
Class _J1_P 17^ 
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Nervous aod Mental Disease Monograph Series No. 26 



The Technique of 
Psychoanalysis 



By 
SMITH ELY JELLIFFE, M.D. 



Nervous and Mental Disease Publisbing Ceinpany 
New York and Washington, D. C, 

1918 

Monograph 



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(See inside back cover page.) 



Nervous and Mental Disease Monograph Series No. 26 



The '1)1^ 



Technique of Psychoanalysis 



BY 

SMITH ELY JELLIFFE, M.D. 



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I 



TABLE OF CONTENTS 

Preface v 

Introduction vii 

Chapter I. The Material to be Analyzed. What not to 

Analyze i 

Chapter II. The Literature, Sources and History of Psy- 
choanalysis 21 

Chapter HI. Opening of the Analysis. The General Sit- 
uations and Preliminary Formulations 28 

Chapter IV. The CEdipus Hypothesis as a Psychological 
Measuring Unit. Its Evolution and Final Stabilization 
as a Social Force 49 

Chapter V. Transference and its Dynamics the Basis of 

Social Integration and the Lever in Psychoanalysis .... 66 

Chapter VI. Transference and Resistance. Opposing yet 

Identical Mechanisms. Practical Signs 87 

Chapter VII. Overcoming the Conflicts. Socialization of 
the Personality. The Use of the Dream in Handling the 
Dynamics of the Transference-Resistance 128 

Index 161 



111 



PREFACE 

" Not in his goals but in his transitions man is great, and the truest state 
of mind rested in, becomes false." [Chinese Proverb.] 

The traveller in a foreign land who keeps to the main highway 
needs no guide. He does not even have to know the language 
of the country for a judiciously distributed pour boire will put 
him in touch with all the more common requirements of his sur- 
roundings. 

With his Baedeker in hand, he may even wander about in 
strange surroundings oblivious to the unknown claque about him 
and return to his haven of safety with an outline of the topog- 
raphy of the city, its bricks and mortar, and possibly its trolley 
cars. But were he to go into the by-ways, were he to reach out for 
an understanding of the rich life that is actually being lived about 
him, he is more or less shut off, and deaf and dumb must needs 
grope about if without knowledge of the language of the country. 

The doctor of medicine is in some such a position — his un- 
explored countries come to him, however, he does not go to them. 
His Baedekers — Gray, Osier, and perhaps a rich library, fur- 
nishing the details of many complicated structures — lead him 
through the more frequented paths of disease processes, but, 
like the real traveller he not infrequently finds himself lost in 
unexplored territory. A new language strikes his ear at every 
specialistic frontier that he would pass; a rich and apparently 
hopeless terminology has to be mastered if he would travel in new 
fields, and if he would know what is going on over the boundary 
he must make it a part of himself. 

It is of no service to him to rationalize his indolence by calling 
this speech new-fangled, absurd or unnecessary. To shut his 
eyes and ears to these new languages, refusing to learn them, only 
hampers himself, and the stream of active intelligence goes on, 
leaving him in an eddy of his own isolation. 

Words are only tools to be used to cut into the facts of nature, 
so that fellow workers, through mutual understanding, can make 
a concerted effort and clear a pathway into the secrets of life. 
The simplest act of reflection will show that the more complex 
the situation, the greater will be the confusion of new tongues 
and the greater will be the need for the construction of new 



Vi PREFACE 

tools — words — to aid the explorer. This is why the problems 
connected with the study of mental activities have so rich a 
terminology and one constantly undergoing evolution. 

Bones, tendons, muscles, intestines, hearts, lungs, have been 
much alike for countless centuries, and have modified little in 
their structures, but the nervous system, an active, changing 
master-spirit in evolution, is constantly reaching out in its attempt 
to grasp the infinite. 

Even the simplest aboriginal inhabitants of an Australian 
village are giants in mental development when compared to the 
earliest products of the age of man. Historical retrospect can 
but imperfectly reconstruct the stages of primitive culture, but 
the connecting links between aboriginal and modern races are 
there. The ethnologist, the archeologist, the anthropologist, the 
student of language, of customs, of laws, of religions has a rich 
material, and already the data available for the understanding of 
the development of civilization and of culture surrounds the stu- 
dent of human nature in bewildering profusion. 

The races of the twentieth century are partakers in this 
heritage of a bountiful past and the individual of to-day is its 
product. To completely understand him entails a knowledge of 
the principal gifts of this inheritance, and he who would grasp 
the innermost causes that sway the human mind must be able to 
reconstruct the stages through which that mind has come in its 
development from primitive culture to modern conditions. 
" What are we," queries Bergson, " in fact what is our character 
if not the condensation of the history that we have lived from our 
birth — nay even before our birth, since we bring with us prenatal 
dispositions?" "Doubtless we think with only a small part of 
our past, but it is with our entire past, including the original bent 
of our soul, that we desire, will, and act." 

These " prenatal dispositions," this " original bent of our soul " 
are a part of the inheritance of which we speak. Everything in 
human life, individual as well as social, has then its historical 
background, its origin, its life history and thus its adequate work- 
ing interpretation. Nothing is trivial, nothing is fortuitous. 

Psychoanalysis outlines the task of interpreting human motives 
from this point of view. How; it will be my privilege to more 
fully set forth. 

"While we sit still we are never the wiser; but going into the river, 
and moving up and down, is the way to discover its depths and its shallows." 

Bacon. 



INTRODUCTION 

The present series of articles is planned for the beginner in 
psychoanalysis. They therefore will contain little that the trained 
analyst does not already know. If because of their simplistic 
character they prove of service to the neophyte my purpose will 
have been accomplished. 

At the outset it seems desirable to give a general outline of 
what psychoanalysis is. For this a bare definition will not suffice. 
The word itself is almost as indicative as such a definition might 
reasonably hope to be. Psychoanalysis is primarily to be consid- 
ered as a method. As such, it seeks to establish a knowledge of 
the development of individual human motives. Just as a chemical 
analysis serves to determine the ultimate composition of this or 
that substance present in nature, so psychoanalysis has for its 
task the unravelling of the ultimate causes of this or that mani- 
festation of human conduct. Psychoanalysis then is merely a 
tool, just as chemical analysis is a tool — both are methodological 
disciplines working with different facts of nature, each seeking to 
determine ultimates in their respective spheres; the former deal- 
ing with data of that portion of the nervous system functioning to 
adapt the individual and the race to reality, the latter working 
with the inorganic and organic substances making up a large 
portion of that reality. 

Not to extend this particular analogy too unduly, it may be 
added that inasmuch as chemical analysis is restricted only in its 
choice of material, so psychoanalysis need have no barrier for 
its activities. It is not a method limited solely to the solution of 
problems of psychopathology any more than chemical analysis is 
confined to the study of pathological human substances. All of 
the questions arising in relation to psychological activities may be 
investigated by the psychoanalytic method. 

It seems to me desirable in this place to clearly emphasize the 
fact that in psychoanalysis we are dealing solely with a method 
for gaining data since one frequently hears the statement that 
psychoanalysis is nonsense. A method, or a tool, is not nonsense. 
Chemical analysis is not nonsense, although bad quantitative or 
qualitative chemical methods may lead to false or nonsensical 
results. The individual chemist may be badly trained in his 

vii 



Vlll INTRODUCTION 

methods and be a poor chemist. This does not invalidate the 
methods of chemistry. Again certain substances may be so com- 
plex in their structure as to defy even the best chemical methods 
at separation and identification ; this argues only for the compar- 
ative crudity of the known analytic resources. It can readily be 
conceded in an analogous sense that the psychoanalytic methods 
now developed may be comparatively crude, but this only sup- 
plies a motive for their betterment rather than an argument as 
to their falsity. 

The crudities of those social instruments, the law and medicine, 
are known to all men, but only the sick egoist argues to do away 
with all law and all medicine. Those healthy nervous systems 
capable of adaptation to the realities of nature are endeavoring 
to improve law and medicine. They seek to minimize their 
crudities and make them better instruments for the obtaining of 
human happiness. In this, as well as in many another task, the 
methods of psychoanalysis are destined to play an enormous role 
in the near future. 

In this place, I can only indicate some of the fields of activity 
in which psychoanalysis, as a method, has already rendered im- 
portant service, leaving for future consideration, when I hope 
to present a summary of the development of the method, the more 
complete statement of its spheres of operation. 

It is chiefly in the realms of psychopathology that psycho- 
analysis first showed its value ; those chapters in medicine devoted 
to the study of the neuroses and psychoneuroses having been 
entirely remodelled by its application. In a similar manner the 
understanding of certain of the psychoses, particularly schizo- 
phrenia (dementia prsecox), paranoia, and the manic-depressive 
group, is undergoing marked transformations as a result of the 
psychoanalytic methods. That large chapter of alcoholism which 
is not an object of interest to medicine alone, but enters into 
almost every sphere of human life, is having most penetrating and 
far-reaching light thrown upon it by the students of the psycho- 
analytic school. 

A new science and application of pedagogy are being reared 
upon the data obtained by psychoanalysis, as witness the masterly 
work of Pfister recently published and made the forerunner of an 
important series of works on pedagogy under the leadership of 
Meumann and Messmer. 

The students of history, anthropology, ethics, religion, philos- 



INTRODUCTION IX 

ophy and art are beginning to feel the value of the material ob- 
tained by the methods of psychoanalysis, and already a shift of 
position with better generalizations is making itself apparent.^ 

It is not my purpose, however, to sketch any such ambitious 
program in these pages. I shall content myself with the rudi- 
ments, and shall deal more particularly with simple medical prob- 
lems ; with such as are met with by the average practitioner, or 
those that come more directly to the student of nervous diseases. 

I believe that every sincere practitioner can practise psycho- 
analysis just as he can practise surgery. In the latter case, with 
a fundamental knowledge of bacteriology he may cut just as far 
as his anatomical knowledge and experience permit him. He may 
limit himself to minor surgery, or he may attempt more difficult 
and complicated operations. So with the methods of psychoanaly- 
sis, if the practitioner will make an earnest attempt to understand 
them, he will be enabled to be of enormous service even when 
only using the simplest fundamentals. There are numerous sick 
individuals who do not need a complex analysis, because they have 
not developed a complex neurosis. Such can be relieved or cured 
by the application of the rudiments of psychoanalysis. This is 
particularly true in the pedagogic field working with develop- 
ing children. On the other hand, it is important for the general 
practitioner to know that the complicated cases need a more 
complete grasp of the methods, just as an operation upon 
the brain requires more than a general knowledge of the princi- 
ples of minor surgery. 

The statement that we are dealing solely with a method, how- 
ever, is incomplete — it is necessary to ask what is the method in- 
tended to do ? and furthermore why is a special method needed ? 

It has already been said that by psychoanalysis one seeks to 
establish a knowledge of the causes for human behavior, that all of 
the psychical activities may be investigated by its means, and that 
it deals with data of the psychic life in its function of adaptation 
to reality. It thus seeks to establish a basis for the understand- 
ing of human conduct. 

Such broad statements, however, are entirely too general, 
especially for the purposes I have in mind in these pages. We 
shall limit them here more particularly to the individual principles 
of human behavior, especially in their application to definite med- 

^The Significance of Psychoanalysis for the Mental Sciences. Nerv- 
ous and Mental Disease Monograph Series, No. 23, edited by White and 
Jelliffe, New York and Washington. 



X INTRODUCTION 

ical situations. The psychoanalytic methods which will be here 
outlined then will bear solely upon practical medical problems con- 
fined within comparatively narrow bounds. We intend to learn 
by them why certain symptoms of disease come into being, and 
what the meaning of these symptoms is for the individual's 
adaptation. We may then be in a position to properly estimate 
the modus operandi of the disorders under discussion and may 
possibly eliminate or modify them for the benefit of the sick in- 
individual. 

And why is a special method needed? This latter question 
can only be answered completely after a more extended review of 
the situations which are to be analyzed. It can be stated here 
broadly that medicine had not been able to satisfactorily explain 
the import of many so-called nervous symptoms. The hypotheses 
were inadequate. Many, in fact most of them, proceeded along 
lines of chemical analogy. 

Pituita, black humors, perverted chemism, faulty metabolism, 
auto-intoxication, indicanuria, etc., these are links in a long his- 
torical chain of such interpretations, the incompleteness and un- 
satisfactoriness of which have been demonstrated for thousands 
of years. Such interpretative formulae might attempt to ex- 
plain why an individual with an incipient schizophrenia, for 
instance, should believe that it was absolutely necessary for her 
when going up a pair of stairs " to go three steps and then stop or 
else suffer from constipation.'' They would say that it was due to 
gastro-intestinal fermentation, possibly a parathyroid hyperactiv- 
ity, or a deficiency of hypophysis secretion. For the sake of 
discussion it may be admitted that possibly such a disease as 
schizophrenia may arise from one or other of these or analo- 
gous metabolic disturbances, but even so wherein does this knowl- 
edge aid in an understanding of the " three steps or constipation " 
symptom ? 

Perhaps the symptom is meaningless and neither needs nor 
can obtain an explanation. This attitude of mind can be under- 
stood. It is very old. It has fostered the type of organic ex- 
planation just mentioned. On the basis of the nonsense of the 
symptom a still more nonsensical interpretation is given. But let 
it be assumed that the symptom means something, that it is as real 
as a dyspnea, and arises from necessary psychical antecedents, 
then at once it becomes apparent that ''auto-intoxication, per- 
verted metabolism," etc., are of no value as explanations ; they 
must be abandoned. 



INTRODUCTION XI 

This is all preparatory to saying that the content of an idea, 
a psychological fact, can never be explained on the basis of per- 
verted chemism, and that every idea, for we shall deal with ideas 
— mental facts — has a basis which is as absolutely determined as 
any other reality of nature. 

This fundamental postulate that every psychological fact is a 
bit of nature with definite laws is the reason why a new method 
of investigation had to be found. The chemical, bacteriological, 
pathological laboratories had shown their sterility in this par- 
ticular field of enquiry. 

Even recognizing this bankruptcy, so to speak, of organic ex- 
planations for psychological phenomena it may be further recalled 
that academic psychology has been far from being a promising 
guiding principle. There have been a number of reasons for this, 
but two psychological tendencies, which had received the official 
sanction of the schools, may be touched upon since the psycho- 
analytic method has shown their inadequacy for its particular 
problems. 

For many years official psychology was limited to the so-called 
physiological psychology. This was practically little more than 
a detailed physiology of the special sense organs. Its study de- 
veloped a mass of information relative to the receptors and the 
conducting mechanisms of the special sense organs, facts of great 
importance, but of little applicability in getting at explanations 
for human conduct. 

Another important attitude of psychology was its insistence 
upon what it was pleased to call its " norms." The famous dictum 
that the abnormal in mental life could only be understood from a 
study of the normal has been one of the chief obstacles to progress. 
Such an attitude of mind could only have come from the labora- 
tory worker unacquainted with the progress made in the empirical 
biological sciences. For here the great advances in knowledge 
have come from the pathological side. The normal has been built 
up out of the pathological. Hence, when Freud, rejecting all of 
the dicta of the official and reigning schools of thought, con- 
structed his psychoanalytic method upon pathological data, he 
followed the path of experience in the other biological sciences, 
and by avoiding the sterile psychology of that fatuous nonentity 
the "normal mind" founded a method of great value. 

No previously existing system of thought could properly form 
a working hypothesis to explain why for this or that individual 



Xll INTRODUCTION 

it was necessary for the patient to "go up three steps or else be 
constipated," or other analogous symptoms which will occur to 
the reader and which are found in abundance in all pathological 
cases, be they hysterias, or compulsion neuroses, phobias, schizo- 
phrenias, or what not. 

The medical historian, acquainted with the various hypotheses, 
can see the thread of truth that runs through all of them. Each 
new century has brought better and better explanations, but it was 
only when, towards the Charcot era, a definite parting with struc- 
tural concepts took place, that psychopathology gained a definite 
right to state to the student of academic psychology that it had 
to be reckoned with, and that previously existing systems of 
thought, even philosophies, would prove inadequate if the patho- 
logical data of medical science in the psychological sphere were 
neglected. 

A method, therefore, which would bring together and unite 
into a genetic or dynamic concept these data of psychopathology 
was much to be desired. It saw its earliest systematic beginning 
in the days of Charcot but it remained for Freud to forge the 
tools of psychoanalysis, and make them of value for every stu- 
dent of psychical phenomena. 

That same historian viewing human endeavor in its search of 
the absolute must realize that psychoanalysis, like other tools that 
homo faher has constructed, will undergo changes and develop- 
ments. The very facts of nature that it reveals will cause it to 
be modified, and if it remain sufficiently plastic, it too can evolve. 

It is no part of the present program to follow any dogmatic 
presentation, but I would remind the reader that a simple state- 
ment of the outlines of the psychoanalytic methods inclines 
towards a certain amount of positivism which I would gladly 
avoid if it were possible. 



THE TECHNIQUE OF PSYCHOANALYSIS. 



CHAPTER I 



The Material to be Analyzed. What Patients not to 

Analyze 

" There is no vice," says Rochefoucault, " that is not better than the 
means taken to conceal it." 

A change of heart has taken place in many quarters of the 
medical profession with reference to the so-called functional man- 
ifestations of the nervous system. The neurotic is no longer to 
be jeered at and made fun of. "Truth from (their) lips prevails 
with double sway, and fools who come to mock remain to pray." 
That multitude of patients who "have nothing the matter with 
them " has commenced to be seen in its true colors. The mem- 
bers of that much greater multitude who have " so many things 
the matter with them," and who, as Dejerine very pointedly re- 
marks, make up at least half of the practice of most physicians, 
will soon be seen, not in the light of sufferers in this or that or- 
ganic realm, but as having psychogenic illness, which make them 
sufferers just as truly as those with "nothing the matter with 
them." When these truths become the universal heritage of the 
profession then the medical iconoclasts and jeerers, such as the 
likes of Pliny, Moliere and Bernard Shaw, will have lost an at- 
tribute of their vocation and can devote their energies to con- 
structive rather than destructive criticism. At the present time, 
however, medicine needs the quips of Shaw to accent its many 
fads and foibles. 

The first requirement of the analyst then is a sympathetic 
attitude towards his material. To pooh-pooh a symptom as 
" nonsense," as " imagination," as " silly," as " make believe," or 
"malingering" is an assumption which has no value from the 
standpoint of the understanding of the symptom. Such an ap- 
proach to mental problems is rather an index of the naivete and 
indolence of the assumer. These universal human attributes must 
be reckoned with and overcome. Thus the analyst becomes a 



2 THE TECHNIQUE OF PSYCHOANALYSIS 

good listener. This listening does not mean the turning of an 
indulgent ear to the plaints of the sufferer, but a comprehending 
and grasping curiosity that counts " nothing as trivial, nothing as 
fortuitous." The analyst must hunger for information about the 
patient's ills, being ever on guard against formulating interpreta- 
tions before the returns are all in. 

All this takes time ! 

In an opening Dialogue between Philopiro, a physician, and 
Misomedon, his patient, written by a Dr. B. Mandeville^ some 
two hundred and fifty years ago, I find the following. 

Misomedon: I have sent for you. Doctor, to consult you about 
a distemper, of which I am well assured I shall never be cured. 

Philopiro: Whatever your case may be. Sir, it is a great Mis- 
fortune you entertain so ill an Opinion of it; but I hope, your 
Disease may prove less desperate than your Fears represent it. 

Misomedon: It is neither better nor worse than I tell you, and 
what I say, is what I am convinced of by Reason, and not a sug- 
gestion of my Fears : But you think, perhaps, I'm a Madman, to 
send for a Physician, when I know beforehand that he can do 
me no good. Truly, Doctor, I am not far from it: But first of all 
are you in haste, pray? 

Philopiro: Not in great haste. Sir. 

Misomedon: I am glad of that, for most of your Profession 
either are, or at least pretend to be in a great hurry. But tho' 
you are at leisure. Can you hear a Man talk for half an hour 
together, and, perhaps, not always to the purpose, without in- 
terrupting him? For I have a great deal to say to you, several 
Questions to ask you, and know I shall be very tedious ; but if you 
can bear with me I'll consider your Trouble, and pay you for your 
Time, and Patience both. Can you stay an Hour? 

Philopiro: Yes, Sir, or longer, if there be occasion." 
1' From which it may be seen that in 1685 as well as today, the 

" physician has failed to understand these patients, and has neglected 

to give time to their study. If the physician is unwilling to utilize 
a great deal of time he can never make an analysis. 
j| Sympathetic insight, intense work in obtaining many state- 

ments of what are facts to the patient, ofttimes with innumer- 
able apparently trivial and unimportant details, and time are the 
primary factors in the opening of an analysis. 

^ " A Treatise of the Hypochondriack and Hysterick Diseases in 
Three Dialogues." London, 1685. 



MATERIAL TO BE ANALYZED 3 

This outline is a commonplace to the trained analyst, but I 
am here writing for the beginner, who wishes to obtain a working 
knowledge of a method. No other attitude of mind will bring any 
useful results. A beginner in chemistry who does not believe 
there is anything in the atomic theory, that H2SO4 as a symbol for 
something is nonsense, and that the two sides of a chemical equa- 
tion convey no information as to what is going on in a chemical 
reaction is not likely to become a chemist and much less a com- 
petent authority on chemical problems. 

Still another situation is in need of emphasis before we ap- 
proach the patient. This is the subject of diagnosis. The young 
student is prone to pin his faith to names. They seem very 
definite to him. Hence he always seeks the diagnosis, and can 
then "consult an authority" or "read it in a book." He is 
prone to shut the book before him, the patient, and read what 
somebody else says about something he knows nothing about, i. e., 
this particular problem. The diagnosis of the mental side of the 
problem is an absolutely negligible matter for the opening of 
an analysis. One's object is to find out what is going on in the • 
patient's mind. The interest should be concentrated on the cor- 
rect ascertaining of the symptoms and on processes^ not on names. 
All diagnoses, it hardly seems necessary to say, are purely artificial • 
creations for social purposes. They represent useful generaliza- 
tions for subsequent comparison and discussion with others later 
on in one's investigations. The attitude of mind that feels that 
its task has been accomplished when the patient is labelled — 
hysteria, compulsion neurosis, neurasthenia, etc. — will never grasp 
nor comprehend the living process going on within the patient. 
All enquiry stops when one dogmatizes at a diagnosis. The 
beginning student, therefore, should thrust the idea of the mental 
diagnosis aside for the more vital problems of getting the facts. 
Naturally the physical diagnosis, if there is one, is another ques- 
tion which will be taken up. 

Mental Facts. — In obtaining the initial history of a patient, 
one's attitude should be an absolutely impartial and uncritical one. 
One should avoid all leading questions, and, in the words of 
Misomedon, one must be willing, yes anxious, "to hear a man 
talk for half an hour together, and, perhaps not always to the 
purpose, without interrupting him." 

This "talk" may be hastily jotted down, or written in short- 
hand, or an effort made to remember it as one sees fit, which 
detail will be discussed later. 



4 THE TECHNIQUE OF PSYCHOANALYSIS 

If one is not certain regarding a detail, the patient should be 
asked to repeat, or explain further, or try to make it absolutely 
certain just what he means by the statement made. Thus, a 
patient says " everything must be clear." 

(Just what do you mean; give me an example. )2 "Why 
under the bed must be clear; the bed must be clear; the closet 
must be clear." 

(How?) "Why I must spread newspapers under the bed, 
then I can see that it is clear. I must roll up the sheets, and the 
mattress, and then I am sure that it is clear. I put white papers 
in the closet and am sure it is clear." 

(Why?) " Because I must make it clear that there is nothing 
there. No Booey (negro) element there." 

This may be as far as such a line of enquiry will take one for 
the time being, or one goes on to another symptom. In a very 
short time the analyst experiences the pleasant sensation that the 
patient feels that some one is really trying to understand what is 
going on in his mind.^ 

It should be the analyst's endeavor, in getting the preliminary 
history, to listen with great care to the patient's own explanation 
and not endeavor to correct it. Usually the explanation is a 
correct one, but it is expressed in terms other than those which 
the non-analytically trained physician usually employs. If the 
analyzer does not understand what the patient means, it will be 
pretty certain that the patient will not understand what the 
analyzer means should he attempt to explain the symptoms. 
Until the analyzer has grasped the exact significance of the situa- 
tion, as the patient sees it, it is nonsense for him to offer an 
explanation. It is of the highest importance not to explain too 
much to the patient about his neurosis in the beginning. The 
detailed reasons for this will appear later. It is, up to this point, 
only necessary for the analyzer to believe that the patient's ex- 
planations must have some truth in them. 

1 am speaking here of mental explanations, not of the banal 

2 Parentheses indicate the analyst's enquiries ; the patient's answer 
follows. 

3 Thus recently while listening very attentively for an hour to the 
"ravings" (?) of a lunatic, the patient suddenly grasped her ear and 
repeated " rubber ear, rubber ear, rubber ear." This turned out to mean : 
(i) You are Hstening to what I am saying, (2) I am listening to what 
you are saying, and (3) some one else is listening at the keyhole. The 
patient's husband was listening at the keyhole. 



MATERIAL TO BE ANALYZED 5 

interpretations which include ''too much uric acid," "a bit of 
nerve tire," " an acid stomach," " floating kidney," " eye strain," 
etc., which have been suggested. Even the medical explanations 
— given by the patient — bits of misconstrued physiology and the 
like, these also should be carefully listened to, not with incredulity 
and impatience, for the patient has accepted them in good faith 
usually from a former physician in whom there once was con- 
fidence. 

After the first unburdening of the patient's mind takes place 
the real work of history taking begins. This may have occupied 
one or two visits. The first task now involves a rigid sorting 
process. lA complete physical examination is usually necessary. 
The symptomatology will often determine just how minute the 
examination must be. 

It must never be overlooked that physical disturbances may 
exist side by side with psychical ones. It is not my purpose to 
discuss the relation of the one to the other in just this place, but 
I hope to make it clear where a practical division may be made 
so far as psychoanalysis is concerned. Anybody may be analyzed 
to his advantage. A patient may be greatly benefited even if 
his headache be due to a brain tumor, but to take the position that 
such a procedure would be justifiable for the treatment of the 
tumor is naturally farcical. It would be on a par with the 
hypnotist's treatment of a mild emotional excitement due to a 
syphilitic arteriosclerotic cerebral softening by the metronome, or 
the internist's treatment of the same by valerian, asafetida or 
bromides ; for forsooth was it not hysterical ? 

) Complicated emotional states due to or accompanied by phys- 
ical disorder are constantly being met with, and the beginning 
analyst must be on guard not to overlook such a somatic disorder. 
On the other hand entirely too much stress may be laid upon the 
latter and the needs for a mental house cleaning overlooked. 
Even so profound a disturbance as the ataxia of tabes, with its 
well-known anatomical substratum, contains, according to as good 
an observer as Maloney,* a very large psychogenic factor in fear, 
which reinforces the ataxia and makes many bedridden who could 
otherwise walk with but little difiiculty. 

In the domain of gastro-intestinal disturbances one constantly 
meets with this interrelationship of the physical and psychical. 
In the great majority of cases, the analyst sees the patient only 

* Journal of Nervous and Mental Disease, November, 1913. 



6 THE TECHNIQUE OF PSYCHOANALYSIS 

after many months of ineffectual gastro-enteric therapy. Under 
such circumstances the need for analysis is obvious. Gastroin- 
testinal references are the most frequent in the psychoneuroses. 

" Man lives to eat " and probably more interest enters into the 
average man's gastronomic ceremonials than into any other form 
of expression. It is not to be wondered at, therefore, that the 
" stomach " should play such a large part in the neuroses and 
that such a mass of ignorance and superstition should still be 
found in all classes of society relative to the nutritive instinct. 
Extremely primitive and animistic notions concerning the food 
function and the processes of digestion still hold sway even among 
physicians. The dietary fads of the latter have been subjects for 
ridicule and satire for years and not without a certain measure 
of justification. Concerning these and the general subject of the 
nutritive instinct more will be said later. 

Before passing to the consideration of the detailed history of 
the patient which is necessary from the psychoanalytic standpoint, 
attention should first be directed to those types of patients who 
should not be analyzed. 

What Patients Not to Analyze 

Perhaps the most important thing for the beginner to know 
is what not to analyze. Even the trained analyst may find to his 
distress that he has unwisely started a psychoanalytic procedure 
to learn later that the method in general will not bring about the 
hoped for result, i. e., the betterment of the patient. For some 
patients psychoanalysis is not the method to employ. The psycho- 
analytic viewpoint however should be held to nevertheless. 

Experience is rapidly accumulating relative to this matter 
and it is my purpose to discuss some of the bearings of this ex- 
perience in the following paragraphs. 

The what not to analyze is intimately related to the why not 
analyze and hence they must be discussed at the same time. 

In most respects there are no rules pertaining to psychoana- 
lytic methods which do not apply to other methods of investiga- 
tion utilized in medicine in the large. Being methods dealing 
more particularly with psychical activities going on in the human 
organism, which activities are plastic and variable, at first sight 
the material obtained seems more intangible than that obtained 
by the use of methods which investigate the workings of nature 
at other levels, i. e., the reflex and the physico-chemical. To illus- 



MATERIAL TO BE ANALYZED 7 

trate: let it be assumed that certain tests are made to determine 
the sensory and motor functions of a limb. These modes of 
examination have revealed paralysis with flaccidity, hypotonus, 
diminution in electrical response, defect in epicritic discrimina- 
tion, painful nerve trunks, swollen, boggy skin, mild cyanosis, 
etc. These results lead one to conclude that the peripheral sen- 
sory and motor neurons in the affected area are undergoing cer- 
tain alterations. These the science of neurological medicine 
summarizes under the broad symbol "neuritis." The facts are 
tangible, one says, because the symbol, neuritis, can group them 
and handle them as an entity. Intelligence puts the facts — ap- 
parently quite definite and determined — together, and draws what 
it calls a logical conclusion. 

The beginner in neurology, it is true, may assume that only 
one thing is represented by the term neuritis, and his query may be 
how to " treat " neuritis, i. e., a symbol, not a thing. The more ex- 
perienced neurologist is aware that after all there is no dynamic 
conception behind the term neuritis — the word only symbolizes a 
series of results and contains only indirect references to causes — 
i. €., changes induced in nerve impulse conducting structures 
(nerves — muscles) by various agents, toxic and mechanical. 
Enquiry should reach out for a genetic conception, and finds 
it either in alcoholic, diabetic, typhoid, influenza or other type 
of poisoning, or in mechanical factors due to a syphilitic menin- 
gitis in the cervical cord, dura, a spinal cord tumor, an osteo- 
arthritis of the cervical spine, a cervical rib, etc. Determinism 
now stands revealed; ignorance is dislodged, and intelligence 
applies the best possible means, chemical or surgical, to over- 
come the difficulty. This is called logical. The whole chain of 
events is based on determinism of facts seen at reflex, i. e., sensori- 
motor levels of the nervous system. One might find illustration 
after illustration which on final analysis would be reducible to 
the single thesis of determinism in the facts of nature at least so 
far as physico-chemico-vltal combinations of phenomena are 
concerned. 

As we have seen, the psychoanalytic method assumes the same 
postulate, namely determinism, for that category of facts which, 
so far as we are now able to see, may adequately be grouped under 
the symbol psychical. The very criteria to be applied in solving 
the " neuritis " problem, here used as an illustration, are pertinent 
for psychical situations. If the facts obtained seem intangible, 



8 THE TECHNIQUE OF PSYCHOANALYSIS 

incomprehensible — such terms denote simply our ignorance of the 
many determinants, i. e., the dynamic factors. There can be no 
intangibility resident in the facts. To say the facts are incom- 
prehensible is a rationalization of individual ignorance. 

Ignorance, however, may be no fault. It becomes so only when 
the individual permits himself to rationalize it, i. e,, give it a 
disguise, which effectually blocks him in the utilization of his 
intelligence, which might otherwise solve the problem in hand. 
Rationalization, therefore, becomes a Janus faced servant of both 
ignorance and indolence, permitting neither to recognize the other 
and thus it proves an aid to inertia, that fundamental property of 
matter which in our school days was defined as " that property by 
which a body at rest tends to stay at rest until set in motion." 

Fortunately, however, for human evolution, Newton's theorem 
goes on to say that " when set in motion it tends to remain in 
motion until stopped." Therefore, if one is able to recognize 
ignorance frankly — is able to avoid rationalizing it, such an indi- 
vidual may be free to choose his pathway. 

But then, why do we say there are patients who should not be 
analyzed? Is this a rationalization of ignorance? 

Let us examine into this ? Is it impossible, or is it unwise to 
analyze them? If impossible, why? and is such a permanent or 
a temporary condition? If unwise, is it (a) Because it will be of 
no service to them; (&) Are there advantages and disadvantages; 
(c) Do the disadvantages work (c, i) against the patient, (c, 2) 
the social body, (c, 3) oneself; (<i) Would psychoanalysis be dis- 
tinctly harmful to patient, to society, to self? 

Stated in tabular form, we have the following general scheme 
for discussion. 

I. Impossible to use psychoanalysis. 
(a) Always. 
(&) Temporarily. 
II. Unwise to use psychoanalysis. 

(a) No service, neither good nor harm ; never, or just then. 
(&) Advantages of psychoanalytic treatment less than its 
disadvantages. 

1. Disadvantages to patient. 

2. Disadvantages to society. 

3. Disadvantages to analyst, 
(c) Do harm 

I. To patient. 



MATERIAL TO BE ANALYZED 9 

2. To society. 

3. To analyst. 

I. The Impossible Cases. — The first type of patient that can- 
not be analyzed is the ignorant one. Under this heading a great 
variety of patients pass in review. In the first place are the idiot 
and imbecile. Many despairing parents hear of the new discovery, 
" psychoanalysis " and they bring their idiot or imbecile children to 
be " cured " by the psychoanalyst. A neurological examination may 
reveal the dynamic factor; either an hereditary defect of transmis- 
sion, a birth injury, an infantile encephalitis, a congenital syphilis, 
etc. A Binet-Simon test affords a rough and ready means of 
obtaining the patient's intellectual status ; a careful pedagogic en- 
quiry estimates the grade of the chances of educability. 

The problem now arises, just what series of criteria will deter- 
mine the character of the advice to the parents, so far as psycho- 
analysis is concerned? If study of the dynamic factors of the 
defects should reveal that there is a hope of relief, i. e., one can 
remove a working cause such as possibly in congenital syphilis, in 
cretinism, in a number of defective states due to definite sensory 
losses (bad eyes, ears, lymphatic constitution, dysthyroidism, dys- 
genitalism, etc.) — then the advice to the parents should be that 
at the present time the patient should be treated for the causative 
factor. Psychoanalysis can be of no service until later possibly. 
Afterwards the question may come up as determined by the results 
of surgical or specific opotherapy. 

Should no such possibly alterable dynamic factor be revealed, 
and should the real causes for the defects stand out as unsur- 
mountable, and a Binet-Simon or other series of intelligence tests 
show inability by the patient to grasp abstract ideas, i. e., mental 
age of five to seven,^ then one must tell the parents that psycho- 
analysis, while it may prove of great value in clearing up certain 
scientific facts which may be of some service to the mass of 
science, and hence indirectly valuable to society at large, so far 
as this particular problem is concerned offers no adequate return 
to the individual patient. The condition is not treatable by the 
psychoanalytic method. The still further question of advice as to 
treatment in general does not lie within the province of these 
remarks. 

But should the analyst, either as general practitioner, or neu- 

5 See Colvin and Goddard in White and Jelliffe, Modern Treatment 
of Nervous and Mental Disease, Vol. I. 



10 THE TECHNIQUE OF PSYCHOANALYSIS 

rologist, undertake the treatment of the patient, although he may- 
have attempted to make it very clear to the parents and friends 
that psychoanalysis is of no service and that he cannot use it, 
nevertheless he must be prepared to hear the criticism that " psy- 
choanalysis is of no service, because Dr. so-and-so (himself or 
other physician) treated so-and-so (said idiot or imbecile) by it, 
and he did him no good," all based upon his particular " failure " 
in the type of patient just discussed. 

To show that this is no phantasy, I shall state that I received 
a letter from a parent in a Western town relative to treatment by 
psychoanalysis of an imbecile daughter — apparently determined by 
an epidemic cerebrospinal meningitis at the age of 4-5. In short, 
I declined to treat the patient, and gave the names of a few schools 
where feebleminded children are cared for and trained, and there 
the matter ended so far as I knew. I do not know how to charac- 
terize my reactions when, from a neurologist of reputed attain- 
ments, I learned a year or so later of the bad results of psycho- 
analysis at my hands, in this individual case. 

This is a extreme type of misrepresentation that has caused 
"the evil things said of physicians," not outside of their ranks, 
but even within them, from the Roman Pliny's first characteriza- 
tion of the Greek physician Asclepiades of B)rthnia to Bernard 
Shaw's skit in the " Doctor's Dilemma." A liberal dose of humor 
will aid the beginner to digest such misrepresentations in his early 
attempts to do the right thing. 

What should be the advice if the patient be shown to be able 
to use abstract ideas, and yet be a high grade imbecile or moron? 

Here it is imperative to recognize that for the beginner at 
least, and especially for the young beginner, psychoanalysis is of 
little or no service. 

Many of these patients slip over into the group where possible 
harm can result. The harm can result if the analysis is clumsy — 
as it is apt to be by the beginner, and secondly, results, in reality 
due to the imbecility, feeblemindedness, etc. — chiefly in the field 
of sexual delinquencies — will be attributed to the analysis. Fur- 
thermore if a positive transference is set up matters may be then 
rendered very difficult and even dangerous (socially) for the 
analyst because of the patient's abundant sexual phantasies. This 
feature will be discussed more fully under a later section. 

In general then all somatic feebleminded types are inapplicable 



MATERIAL TO BE ANALYZED II 

to psychoanalysis so far as therapeutic aims are in view. Psycho- 
genic types are particularly fit for psychoanalytic therapy. 

The contrasting or demented types form another large group. 
Here " dementia " is used as a broad and loose conception similar 
to '' feeblemindedness." Yet the same criteria may be applied to 
them. If the deterioration of a once fairly average intelligence is 
a result of irreparable factors, and the grade of deterioration is 
such, as outlined by intelligence tests (Sommer, Ziehen, Kraepe- 
lin, etc.), that intellectual plasticity is gone and new concepts 
cannot be grasped, then psychoanalysis is impossible. 

There are a number of older patients who by reason of emo- 
tional upsets (loss of wife, husband, or money) appear far more 
deteriorated than they really are. Here a partial analysis may 
clear up the emotional disturbance and render the patient much 
better able to handle his conflicts. As a rule a complete analysis 
is unnecessary — often impossible. There may be enough plasticity 
for these patients to grasp the chief mechanisms at fault. They 
are not growing old gracefully, one might say, but they are not 
plastic enough to be made over and the analyst is unwise who 
would attempt it. 

General paresis is not to be analyzed save from the standpoint 
of scientific interest. Inasmuch as cyto-biological tests should 
make it impossible to confuse the early " neurasthenic " signs of 
paresis with a psychoneurosis, there is now little justification for 
the loss of valuable time entailed by the use of any other form of 
treatment than that for the syphilis. 

Patients with other dementing processes, alcoholic, presenile, 
tumor, etc., are likewise impossible and should be rejected. Very 
valuable psychoanalytic material may be obtained from the " ram- 
blings " of a senile dement, or a paretic, but such apply to the inter- 
pretative art which may be of service for other patients rather 
than of value in the treatment of the producer of the symptoms. 

Acute maniacal states are manifestly unapproachable — i. c, so 
far as the present outlook is concerned. The productivity of such 
patients is often readily analyzable, and one's psychoanalytic com- 
prehension obtains invaluable illumination from them; one may 
obtain a complete picture of the entire conflict as it is bursting 
like a Gatling gun.^ Such an interpretative analysis may be of 
great service later on when the patient has made a spontaneous 
recovery but practically all attempts to modify the course of an 

6 McCurdy, State Hospital Bulletin, 1913. 



12 THE TECHNIQUE OF PSYCHOANALYSIS 

acute excitement in a manic-depressive psychosis by analytic prc^- 
cedures have proved unavailing. 

Similar conditions rule in other acute excitements. Acute and 
subacute deliria may be impossible to analyze if very acute. The 
subacute delirium of alcoholic hallucinosis in an intelligent indi- 
vidual may give surprisingly good results by modified analytic 
treatment, however, and also lead to the uncovering of the motives 
for the alcoholism. 

Acute katatonic excitement is unapproachable. If a positive 
transference becomes established the patient may be controlled 
somewhat, but there are few analysts who have worked enough 
with katatonics to enable them to establish a working transference. 
Severe depressed states are very difficult or impossible for the 
beginner. They are nearly all potentially suicidal and all of the 
precautions of the older methods, especially in guarding against 
self-destruction, must be held in mind^ in approaching these cases. 
Psychoanalysis reveals suicidal ideas earlier and more definitely 
than any other procedure and hence is justifiable for a short time. 
Mild depressed states in the young are very amenable to psycho- 
analytic treatment. 

Mute patients are unapproachable, but it should be remembered 
that there may be patients who while verbally mute yet speak in 
every movement of the body. Only the trained psychiatrist with 
analytic tendencies can interpret these, however, and they should 
offer only opportunity for observation and study rather than hope 
for therapy in the hands of a beginner. I have sat by a mute 
katatonic for an hour attempting a variety of openings with all 
the zest which in my younger days had been given to a game of 
chess. One must be anxious to do just that, sort of thing if one 
hopes to surprise nature into giving up a psychical fact. 

Certain homosexual types are to be approached with consid- 
erable caution. Negative transference may readily be set up and 
then such patients babble and gossip about the analyst and malign 
and slander him most amusingly. They go about calling this or 
that reputable and painstaking neurologist a fakir or a quack — 
two epithets too frequently bandied about by careless narcissists. 

II. The groups for which psychoanalysis would be unwise are 
naturally less capable of clear formulation. Wisdom and lack of 
wisdom being comparative terms their use as guides to conduct 
imply that the problems are open. 

'^ See Farrar, White and Jelliffe, 1. c. 



MATERIAL TO BE ANALYZED 



13 



(a) There is a group of patients which does not come within 
any clinical classification so far as neurology and psychiatry are 
concerned for whom psychoanalysis is not impossible but for 
whom we can expect little from its application. Its application is 
not going to cure the patient. Some help may be hoped for, but 
in general the patient has established a fairly good working basis 
for himself and does not really intend to be disturbed. 

It is highly important to recognize this group with its sub- 
groups for there are many individuals in them, and as it is the 
habit of such individuals to go from doctor to doctor they are the 
chief factors in carrying gossip, and in giving the usually very 
tenuous basis for the misinterpretations which result, not directed 
to psychoanalysis alone, but in all branches of medicine. I call 
them the " little bird " group. They are all types of personalities, 
but most of them have little interest in anything, are somewhat 
introverted, but are capable of establishing a superficial rapport 
with great ease, and fall away quickly to seek a new attachment. 
One cannot escape them. Whether one treats them or not they 
will say things to the next claimant for their favor which con- 
scious as well as unconscious rivalry seizes upon to augment bad 
feeling among us. They are not infrequently superficially clever. 
There is an active and passive subgroup. The women are chiefly 
in the former, the men in the latter. The former are more mali- 
cious in their comments on the other doctors. They seem to like 
to set each other by the ears. They give, if one allows them, the 
petty gossip of the households. They know all the "backstairs 
gossip." " Dr. So-and-so treated them for this, but Dr. So-and-so 
said it was that, and now you are the only one to understand." 
They are interesting semi-invalids, at times even " kittenish." 

Many of these patients do not care to get well. They use their 
neurosis to keep up a type of " peeping." They will not see 
themselves, and have little courage to do any real work. Parasi- 
tism is a marked unconscious factor. They are molluscs, either 
dependent upon a mother, a father or brother, or a rich uncle, or 
some benefit society. The doctor is a vicarious ever-changing 
substitute, and they give him the little tittle-tattle about his fellow 
practitioners that he not infrequently though often unwittingly 
likes. 

When once embarked on an analytic treatment with these 
patients they hang on and on so long as their small vanities and 
foibles are undisturbed. When the analytic probe bears heavily 



14 THE TECHNIQUE OF PSYCHOANALYSIS 

Upon these they pout and fall away. A strong insistence upon 
having " backbone " and " standing up to their task " causes a 
further flight, this time perhaps to the gastro-enterologist, or the 
gynecologist, or what not, and the analyst wakes up to find that 
his work has only contributed to the patient's auto-erotic phan- 
tasies, usually of an infantile or adolescent type. Only a wide 
experience will make one acquainted with all the variants of this 
type. Essentially they do not wish to get well. To do so would 
make them have to work, and this is impossible. 

A further small series of this group is found frequently among 
the well-to-do. They are not parasites in the sense of the word 
just used. They may be independent financially, but are en- 
crusted by the usages of their social milieu and are analyzed with 
great difiiculty. The democratic attitude of psychoanalysis, it's 
pragmatic and humanistic tendencies run counter to their aristo- 
cratic, rationalistic and individualistic mode of education. They 
are very indolent. Novel reading, drug taking, alcoholism and 
social fussing constitute their most frequently used pathways to 
escape from being bored to death; while auto-erotic fantasy, 
sexual tittle-tattle, definite liaisons or perversions may be the chief 
excitements that apparently give value to life. 

They buy attention with their money; look for flattery and 
self indulgence, and utilize the physician as a blind for the carry- 
ing out of their desires. They expect to be told to do the proper 
thing in " cures." If their set goes to Carlsbad or Hot Springs 
they expect their medical advisor to know the present styles in 
sanitaria, health resorts, etc., and use his prescription as a lever 
to move obstacles, if such exist. Psychoanalysis is far too serious 
and circuitious a method to interest them beyond that which may 
have previously stimulated their curiosity regarding its so-called 
" sexual sniffling." Since in actual psychoanalytic practice no 
such thing exists such patients as a rule lose interest and move 
on to a " new " medical interest that will amuse them. Gastro- 
intestinal lavage has great vogue with this group, contributing as 
it does to satisfy their anal erotic trends. 

{b) The group of patients for whom psychoanalysis would be 
more disadvantageous than advantageous is difficult to outline; 
yet for the beginner certain patients are best let alone. The ad- 
vantages to be gained are doubtful. 

I would place in this series those individuals who do not seri- 
ously take up the subject. They may be somewhat sick but out 



MATERIAL TO BE ANALYZED 1 5 

of motives chiefly of curiosity, they begin on a psychoanalytic 
procedure, but soon fall by the wayside by reason of the time 
needed, the cost, or the mental application. They may start in all 
sincerity but they are more or less superficial natures who tire 
readily and " do not see the use." They are unwilling to go 
through the process of mentally dissolving themselves in order to 
obtain a sometimes unflattering likeness of themselves. 

Many narcissistic individuals belong to this group. 

(c) One may read in the form of general statements made by 
a number of critics of the harm that psychoanalysis may do. 
These critics are all in accord in denying to the sexual any etio- 
logical significance, yet strangely enough psychoanalysis, thought 
of by them as dealing solely with sex matters, can do the very 
thing that they say is impossible for sexual ideas to produce. Ex- 
act details are not available, and one awaits the analysis of 
Hoche's^ anti-psychoanalytic questionnaire, which was launched 
in 1913 with all of the signs of an active partisanship. The three 
histories quoted by him are ludicrously inadequate. This is not 
the place chosen to discuss the various objections to the psycho- 
analytic procedures, or to the hypothetical concepts that underly 
them. Psychoanalysis is not a subject for general debate. It is 
too intimate a thing to permit discussion. One may say what one 
has observed and leave the matter at that. 

It may readily be admitted that bad psychoanalysis exists, and 
that such can do harm; but there is much bad medicine and 
bad surgery evident wherever one may wish to turn. Meddle- 
some surgery is a by-word — so may meddlesome psychoanalysis 
become one. Freud has already fully discussed what is well 
termed " Wild Psychoanalysis,"^ a paper that all aspirants to psy- 
choanalytic understanding should thoroughly know. Fictitious 
psychoanalysts will arise. They are already to be found on the 
board walk at Atlantic City, and other places, with the palmist, 
chiropractic, etc. 

Even the harm done by " bad psychoanalysis " may not be as 
great as that done by a " good neurologist," who as a result of an 
examination of a patient with a neurosis gives a learned diagnosis, 
lays down minute rules as to diet, regimen, hydrotherapy, etc., and 

s " Ueber den Wert der Psychoanalyse," Archiv, f. Psychiatrie, Vol. 
51, 1913, p. 1055 ; " Eine psychiche Epidemin unter Aerzten," Med. Klink., 
1910, No. 26. 

9 " Selected Papers on Hysteria and Other Psychoneuroses," Nervous 
and Mental Disease Monograph Series, No. 4, 2d ed., Chapter XI. 



l6 THE TECHNIQUE OF PSYCHOANALYSIS 

yet is oblivious to the dynamic factors of the disorder under con- 
sideration. The analyst may have set up a strong antipathy, yet, 
because it contains a real element of dynamic interpretation, it may 
ultimately work out to the patient's good unconsciously, whereas 
the learned diagnosis, which often is nothing more than the anal- 
ysis of the acquired meaning of a word, may shut the door to 
a minute investigation of the behavior of a thing, and the patient, 
under rationalistic dogmas, is treated for one series of symbols 
after another, yesterday uric acid, today gastro-intestinal tox- 
emia, tomorrow dental sepsis, and all without essential relief. 
This type of so-called orthodox medical treatment may go on 
for years and the final chronic nervous breakdown has to be 
patched up in some way if possible. 

Beginning analysts should avoid working with hysterical young 
people; they should not attempt a compulsion neurosis without 
some experience, and only after considerable work will an analysis 
of a beginning dementia prsecox fail to perhaps temporarily in- 
crease the patient's excitement. Most harm may come to the ana- 
lyst himself. With paranoid praecox, or certain of Kraepelin's para- 
phrenic group^^ the untrained analyst is liable to establish a nega- 
tive transference and later actual violence may be attempted upon 
him. He may be assured that malicious gossip will be directed 
against him. 

A similar state of affairs may result from the analysis of 
certain compulsive states, and the analysis of homosexual situa- 
tions is best let alone by the beginner for closely related reasons. 

With reference to compulsion neuroses, the beginner should be 
on his guard against taking on free cases. These patients are 
analyzed with great difficulty; they take an immense amount of 
time, spread over many months, and unless the analyst is prepared 
to make a complete analysis independent of personal sacrifice, he 
is wiser not to embark upon one. If he is compelled by stress of 
economically more important work to neglect the patient, espe- 
cially if he be a male — usually all with strong homosexual com- 
ponents in their libido, — he is liable to set up negative transfer- 
ences, and the patient is apt to curse the analyst right royally. 
One trained in psychoanalysis recognizes that after all behind this 
vituperation in the unconscious their lies a very great regard for 
the analyst so inveighed against, but such patients' utterances 

10 See Singer, " Kraepelin's Concept of Dementia Prsecox," Journal 
Nervous and Mental Disease, June, 1914; Kraepelin, " Lehrbuch," 8th ed., 
Endogene Verblodung, 1913. 



MATERIAL TO BE ANALYZED 1 7 

when heard by others constitute a large part of the as yet detailed 
evidence against the value of psychoanalysis. Still the analyst 
who has committed this fault out of his sympathy for one in great 
distress, should know that he is liable to harm himself the most. 
He rarely harms his patient, although the stupid outsider is apt 
to take it as a great faux-pas on the part of the analyst. 

Particular caution should attend the analysis of young girls 
suffering from hysterical attacks, especially when such represent 
distorted erotic fantasies, or when the hysterical symptom serves as 
a direct sexual (in the narrow sense) gratification, and represents 
a part of the sexual life of the individual. Here a very strong 
transference is apt to result which often contributes new s)mip- 
toms to the neurosis. The development of such new symptoms 
serves to emphasize the necessity for not continuing an analysis, 
or for putting it in the hands of a woman physician trained in 
analysis. 

Psychoanalysis, even of a most careful kind, at times does 
harm to the analyst as well in many such cases. The almost 
pathological transference causes the patient to interfere with the 
analyst's time, and when she is rebuffed, strong resistances de- 
velop and the hysterical patient becomes an active enemy to the 
physician. She talks about him continuously; discusses all his 
affairs, particularly how he tried to misuse her (her own non- 
realized wish-fulfilment). She carries gossip and scandal where- 
ever she can get an opportunity, and may be able to place the 
analyst in a very unpleasant position. 

In justice to many hysterical patients however it should be said 
that bad psychoanalysis cannot hide behind even this well recog- 
nized situation. In the majority of instances, the analyst has 
been partly at fault in creating such a condition. He may fail 
in his duty, and succumbing to his own weaknesses, redouble the 
patient's erotic fantasies by excessive tenderness. He thus cre- 
ates new situations which involve him as well as his patient in the 
greatest difficulties. (See chapter on Transference.) 

One not infrequently finds that a certain group of patients 
unconsciously start out with the idea of getting the analyst " inter- 
ested " in them. They then slowly or rapidly substitute one 
group of symptom symbols, usually at first highly resistive by 
their opposites, namely great solicitude and interest in the analyst 
and his work. They unconsciously flatter the analyst and finally 
may succeed in getting the upper hand. The psychoanalytic probe 



1 8 THE TECHNIQUE OF PSYCHOANALYSIS 

can no longer do its work. The analyst is powerless. He has 
perhaps succumbed to his own (auto-erotic, money) complexes, 
and his usefulness is seriously hampered. 

This type is seen particularly in daughters where the father is 
somewhat of a tyrant. Notwithstanding a violent conscious anti- 
pathy on the part of the daughter to the father, the dreams are 
apt to show definite father image phantasies and the " prostitution 
complex" is fairly well marked. The girl is usually willful and 
spoiled; usually gets a poor education and thus with but few 
libido channels open usually turns to social forms of exhibition- 
ism, ofttimes very ingeniously masked, and becomes an accom- 
plished breaker of hearts. Those with strong father fixation 
phantasies are very inconstant. They are the Kipling Vampires. 
Psychoanalysis makes them even more dangerous since they learn 
better to conceal their "cat and mouse" game. When beauty, 
wealth and social postion are combined the analyst who estab- 
lishes strong transferences must be specially on his guard. 

If the analyst will realize that every transference also con- 
tains a strong resistance, and that he, the analyst, is only a surro- 
gate for the father or brother image of the infantile libido of the 
patient, it should serve to keep him from losing sight of the main 
object of a psychoanalytic cure, i. e., the making of the patient 
free and independent of his infantile fixations. 

It must always be borne in mind by the analyst that the psy- 
choanalytic method develops special means by which strong trans- 
ferences are set up, just as in hypnosis similar transferences may 
be seen, but in a much more limited group of cases. It also 
should provide the analyst who is conscientious in his work with 
special means for handling these usually very strong transferences 
which are seen in all types of neurotics. (See chapter on Trans- 
ference.) 

That which is true of hysterical states is doubly so with manic- 
depressive psychoses. These are dynamite bombs and may cause 
much anxiety to patient as well as analyst. In a number of in- 
stances the results of even a few talks are very promising; occa- 
sionally this promise holds good, but more often the transference 
becomes unmanageable to the patient and is apt to cause much 
discomfort unless handled with great skill. A thorough psycho- 
analysis is best avoided. Stekel has called attention to this and 
as a result of his experience warns against the analytic treatment 
of manic-depressive states.^^ 



MATERIAL TO BE ANALYZED 1 9 

My own experience confirms his and shows how the trans- 
ference may become violent, passing over to most persistent 
lovemaking. On repulsing these patients, a thing which cannot 
be avoided, although it must be done very carefully, they reject 
the idea that their love is only a transference, a father-image 
phantasy; they threaten to make away with themselves, uncon- 
sciously to arouse the analyst's sympathy, and gain tenderness 
and physical contact. They " will not leave the office," " they 
are only just so many patients," "they are numbers." They are 
very jealous of the other patients and soon make it impossible for 
the analyst to carry on his work. Much will depend upon the cul- 
tural type as to just how one can avoid these unpleasant cases. 
With individuals of fairly well-grounded intelligence one can 
avoid their falling into states of great depression where they 
threaten to kill themselves or kill the analyst. Stekel advises a 
course of Dubois'^^ reeducation dialectics for these patients rather 
than a true analysis in the Freudian sense. It is better to deal 
with more superficial structures and leave the deeper motives 
untouched. 

With some very intelligent individuals with mild attacks, or 
in free intervals, a very definite gain may be made by a complete 
analysis. 

It is the analyst's duty in these cases to explain the situation 
to the relatives or friends clearly before offering any relief. 

Another very important chapter in psychoanalysis where harm 
may come to the analyst is that of consultations. At times one is 
called in by a colleague to see a patient who has a psychoneurosis 
or a mild psychosis. It may be evident from the start what par- 
ticular complex situations are at the basis of the situation. To 
even start an analysis is bad technique, for it is surprising to see 
how rapidly a transference may be set up in these patients by 
one trained in psychoanalysis. To permit this transference to start 
will endanger the analyst's standing with his colleague. He may 
tell him, if he has the courage, that his enemas, his arsenic, his 
this and that, are of no service for this particular patient, who 
needs mental therapy. The colleague will rarely respect the 
analyst's point of view, nor call him again in consultation. The 

^^ Stekel, " Die Ausgange der psychoanalytischen Kuren," Centralbl. f. 
Psa., Vol. Ill, p. 300 in particular. 

12 P. Dubois, " Psychic Treatment of Nervous Disorders." Tr. by Jel- 
liffe and White. Funk and Wagnalls, N. Y. 



20 THE TECHNIQUE OF PSYCHOANALYSIS 

colleague may ask the analyst to give the patient a " few " psy- 
choanalytic treatments, as if psychoanalysis were like the " laying 
on of hands," or he may suggest that a cooperative type of treat- 
ment be undertaken; he to take care of the physical ills, the 
analyst to care for the mental ones. This is also a delicate situ- 1 

ation since, as a rule, there are " no physical ills " to be treated. 
The gastroptosis, enteroptosis, dental sepsis, colon stagnation, etc., 
etc., so far as that particular case under consideration is con- 
cerned, are gross animistic superstitions ; the psychical factors are 
the important ones. It is far better for the analyst to say that the 
thing is impossible ; that the internist should continue to do what 
he can do, avoid meddlesome surgery, and, after a certain length 
of time, if nothing is accomplished, turn the case over to the 
analyst, who will take his try at it, promising to return the patient 
to his colleague, after a mutually agreed upon reasonable time for 
treatment. This ideal needs no elaboration. A stage of intel- 
lectual culture which permits so many animistic notions to control 
the thinking of the great majority of the population is not one 
sufficiently enlightened however to carry out such an ideal. 

It is highly important to remember that psychoanalytic ex- 
planations are rarely understood by the laity, hence in one's talks 
with the parents one should avoid all interpretations. The least 
said to anxious mothers, fathers, other relatives and friends the 
better. One can only insist that the best possible will be done and 
results will be the criterion of the treatments. It is highly ad- 
visable for the analyst to point out that his treatment is exclusivley 
medical, and that it is not metaphysical or mental healing, nor 
anything of that ilk. It is medical sense applied to particular types 
of problems. It is imperative that one who would practice psy- 
choanalysis should have a medical training, or work in close touch 
with a physician. The independent non-medical psychoanalyst 
who pretends to really practice medicine is a doubtful asset to the 
community. Properly trained psychoanalysts are needed greatly 
in medicine and the serious one's are willing to work under med- 
ical guidance. 



CHAPTER II 
The Literature, Source and History of Psychoanalysis 

There is no royal road in psychoanalysis, for every analysis is 
after all a highly individualized problem. At the same time there 
are general principles, else a technique could not be evolved. In 
actual practice a number of different approaches may be utilized, 
and just as in the royal game of chess there are recognized open- 
ing, mid game and end problems, so in psychoanalysis one's 
method of application of fairly well understood and accredited 
principles must be carefully chosen v^ith special reference to the 
character of the case in hand. 

Among those of considerable experience it is not infrequent 
to find marked diversity of opinion regarding the chief factors 
and the most useful methods to be employed in analysis. The be- 
ginner is often overwhelmed with ''ex cathedra" statements 
" never do this," and " always do that " ; Freud says this and Jung 
says something else; Adler advises so and so, Ferenczi the oppo- 
site. One will say, " I always begin this way," another says, " No, 
begin this way." 

This is to be expected in view of the comparative newness of 
the present methods, and the highly complicated nature of the 
material to be studied. The analyst himself should recognize, 
however, that psychological analysis is by no means new, even if 
that special brand of it, psychoanalysis, has been given a new 
name, and is without doubt a more concrete and adequate group 
of working hypotheses than those heretofore utilized. 

The interest taken in the mental life is very old. From the 
earliest times different aspects have been carefully observed. Of 
modern students of these Dessoir^ has given us a very useful sum- 
mary. In this summary the development of the religious ideas, of 
the vital, natural and scientific processes involved, and of the 
practical and artistic knowledge of human life are termed psy- 
chosophy, psychology and psychognosia respectively. These are 
three view points, three objective modes of approach to the prob- 

1 " Outlines of the History of Psychology," Max Dessoir, The Mac- 
millan Co., New York, 1912. 

3 21 



22 THE TECHNIQUE OF PSYCHOANALYSIS 

lem of the psychical. In this scheme of things it is clear that 
psychoanalysis would more clearly be grouped with the third, i. e., 
with psychognosia. 

Early attempts at knowledge of human nature as deposited in 
maxims and aphorisms are well crystallized in the sayings of the 
gnomic poets of the tenth to the fourth centuries B. C. The 
Bible and Greek philosophies contain most of these. Aristotle's 
studies of the temperaments are full of psychognostic (psycho- 
analytic) wisdom. From the days of antiquity there are rich col- 
lections of autobiographies, tales, lyrics, soliloquies, and day books 
all having in common the effort of the individual to express him- 
self, to gain self-knowledge. As Dessoir states, schemes of peda- 
gogic moral self-examinations are abundant from the Golden 
Verses ascribed to Pythagoras of the Pre-Christian era, through 
Augustine's Confessions (400 A. D.), to those of Rousseau, and 
the moderns. Even in most recent times the value of such mate- 
rial is most strikingly set forth in Freud's masterly analysis of 
the Schreber autobiography.^ 

French characterology was a compact mass of rich psycho- 
gnostic material in which the works of Madame de Guyon, La 
Chambre, La Rochefoucauld, La Bruyere, and Chamfort stand out 
as monuments of serious attempts at practical psychology. La 
Chambre made use of dream, chiromantic and astrological mate- 
rial, and if one will take the trouble to read behind the words it 
will be seen that he might have been termed a psychoanalyst. 
Thomasius who used a French version of an early work by 
Gracian, also a psychognostic of note, as early as 1687, offered 
the Elector Frederick III the knowledge of the "new invention," 
by which it is possible " to know what is hidden in the hearts of 
men, even against their will, from their daily conversation." 
Thomasius gave a series of rules and regulations by which the 
characteristics of a man and his conduct might be deduced. Many 
of these are matters of lay knowledge to-day. Even as early as 
1783 P. H. Moritz started a psychological magazine for psy- 
chognostic observations. Its program as sketched by Dessoir is 
illuminating. It showed the following characteristics : suspen- 
sion of moral judgment, collection and comparison of facts, special 
attention to half pathological phenomena which lie outside of the 
ordinary course of mental life, cultivation of child psychology and 
the psychology of language. 

2 See " Freudian Contributions to Paranoia Problem," by C. R. Payne, 
Vol. I, No. I, Psychoanalytic Reviezv, p. yy. 



HISTORY OF PSYCHOANALYSIS 23 

During the 19th century, however, scientific discussion of psy- 
chognostic problems stagnated, and were superseded by the novel, 
which took possession of all the practical knowledge of human 
nature. It was gradually forgotten that concrete as well as ab- 
stract problems of the human soul were accessible to scientific 
treatment. The psychoanalytic movement is therefore a revival 
of these earlier psychognostic attitudes towards the understanding 
of human conduct. 

The beginner in psychoanalysis will get a better perspective 
towards his own work should he review some of this early psy- 
chognostic literature. The many " ipse dixits " of his surround- 
ings will find a better placement in the general scheme of fhings. 
Some acquaintance with the general development of the history 
of philosophic systems^ will also be of considerable aid in under- 
standing the general scope of his patients' special philosophies of 
life, while a bird's eye view of the intellectual history of mankind 
is invaluable.* 

I do not believe that a sound psychoanalytic technique can be 
built up unless one has a fairly accurate placement of anthro- 
pological data. More will be said regarding this material in dis- 
cussing symbolism, but here it may be noted that the Old Testa- 
ment and Frazer's volumes on the Golden Bough (Macmillan 
Co.) are almost indispensable. 

I am presupposing, all along, that the aspirant for psycho- 
analytic knowledge is trained in neurology and psychiatry. An 
intimate practical knowledge of the latter is essential. 

Of the more strictly psychoanalytic literature itself the major 
part is in German, but a number of the more fundamental studies 
have been translated, chiefly by American workers. I purpose 
suggesting some of the more important psychoanalytic papers 
which the beginner in psychoanalysis should read. It may be 
emphasized here thsit/ patients should not read them. The works 
of Freud stand out as most essential. A complete bibliography 
(1893-1909) of Freud's contributions to psychoanalysis may be 
found in the Jahrbuch fiir psychoanalytische und psychopatholo- 

3 Putnam, *' A Plea for the Study of Philosophic Methods in Prepara- 
tion for Psychoanalytic Work," Journal of Abnormal Psychology, Oct.- 
Nov., 191 1, p. 249, 

*J. H. Robinson's "Outlines of the History of the Intellectual Class 
in Western Europe," Columbia University, 2d edition, 1914, will prove the 
best guide available for one's general historical reading along these pro- 
posed lines. 



24 THE TECHNIQUE OF PSYCHOANALYSIS 

gische Forschungen, vol. I, p. 546. Some of his shorter papers 
are collected in his Sammlung kleiner Schriften, i, 2, and 3d 
series [Deuticke, Vienna]. A translation of some of these is to 
be found in volume 4 of the Nervous and Mental Disease Mono- 
graph Series, '' Selected Papers on Hysteria and Other Psycho- 
neuroses '' [2d ed.]. Freud's "Three Contributions to the Sexual 
Theory" (Vol. 7 of the same series in translation) is highly im- 
portant, also his " Psychopathology of Every Day Life," and his 
** Interpretation of Dreams." Both of these have been well trans- 
lated by A. A. Brill (The Macmillan Co., New York). A highly 
important series of lectures on psychoanalysis given by Freud at 
Clark University in 1909 is to be found in the American Journal 
of Psychology for 1909, 1910. In the same series of the Amer- 
ican Journal of Psychology there are important papers by C. G. 
Jung and S. Ferenczi, neither of which should be overlooked by 
the beginner. Further translations of Freud are available in his 
Wit, and Leonardo da Vinci and his beautiful little classic on 
Jensens, Gradiva ("Delusion and Dreams") all published by 
Moffatt, Yard & Co., New York. In a series of monographs en- 
titled " Schriften zur angewandten Seelenkunde " [Deuticke, 
Vienna], edited by Freud, a number of valuable studies have ap- 
peared. Those by Abraham, Rank and Riklin are noticed here- 
after. Two volumes on Psychoanalysis, both by pupils of Freud, 
are in Engilsh. They are not systematic presentations but collec- 
tions of miscellaneous papers, but are of great value to the stu- 
dent. They are by A. A. Brill (W. B. Saunders & Co.) and 
Ernest Jones (Wm. Wood and Co.). A comprehensive and pre- 
cise outline of the Freudian postulates is given by Hitschmann in 
" Freud's Theories of the Neuroses " (Vol; 17, Nervous and Men- 
tal Disease Monograph Series, in translation by C. R. Payne). 
This is the most valuable single volume outline of the development 
of the psychoanalytic hypotheses. 

One highly valuable general work on methods is that of Oskar 
Pfister, "Die psychoanalytische Methode" (J. Klinkhardt, Leip- 
zig). This is a work of 500 pages, written by a teacher and min- 
ister, and is especially valuable to the beginner. A translation is 
obtainable. It contains copious bibliographical references. One 
other monograph along modified psychoanalytic lines which is of 
great value is that of Ludwig Frank, " Afifektstorungen " (Julius 
Springer, Berlin). Furthermore L. Kaplan's GrundzUge d. Psy- 
choanalyse, and specially Jung, "Wandlungen und Symbole der 



HISTORY OF PSYCHOANALYSIS 25 

Libido" (translated by Dr. B. Hinkle (Moffatt, Yard & Co., Bos- 
ton) ) are to be recommended. More general approaches may be 
obtained in Wm. A. White's "Mental Mechanisms, Foundation 
of Character Formation, and Mental Hygiene." W. Lay has 
written a short work on '' Man's Unconscious Conflict " which may 
be recommended. Jelliff e's chapter on Hysteria in Osier's " Mod- 
ern Medicine" contains a discussion on psychoanalysis, and 
Jelliffe and White, " Diseases of the Nervous System," 1917, is 
a work setting forth the dynamic concept for all problems of 
nervous pathology. 

It is surprising that the French literature upon psychoanalysis 
should have been very tardy. Up to the present time the only 
noteworthy resume of Freud's writings in French are contained 
in a volume by Regis and Hesnard — " La Psychoanalyse des 
Neuroses et des Psychoses." This volume contains a complete, 
though slightly one-sided, digest of the chief psychoanalytic re- 
searches. It is worth having, since it also presents some sug- 
gestive bibliography from French and Russian sources. 

The periodical literature bearing on psychoanalysis is very ex- 
tensive. Fortunately it can be more or less readily followed. In 
1909 the Jahrhuch fiir psychoanalytische und psychopathologische 
Forschungen (bi-annual) (Deuticke, Vienna) was begun by Bleu- 
ler and Freud and edited by Jung. In this first volume (p. 546) 
the chief psychoanalytic literature to 1910 is given. In Vol. II 
of the Jahrhuch (p. 316) Jones gives a complete list of all the 
available English and American work, some 192 titles, much of 
which, however, is not strictly analytic. Neiditsch (p. 347) gives 
a short note on the Russian literature, Assagioli (p. 349) one on 
the Italian literature, while (p. 356) Jung gives a complete sum- 
mary of the chief contributions of Swiss authors to 1910. The 
Jahrhuch is now in its seventh volume and contains much lengthy 
and thorough analytical material. Complete abstracts are appear- 
ing in the Psychoanalytic Review. 

The need for a more frequent publication which would present 
a more ready coordination was met in 191 1 by the establishment 
of the monthly Zentralhlatt fUr Psychoanalyse, edited by W. 
Stekel (Bergmann, Wiesbaden). This contains shorter articles, 
copious abstracts and literature citations, and was for a time the 
official organ of the International Society of Psychoanalysts. It 
is a highly valuable publication for the analyst. For the more 
general needs of philosophical, historical, ethical and general prob- 



26 THE TECHNIQUE OF PSYCHOANALYSIS 

lems which might receive illumination fram the psychoanalytic 
hypotheses, Freud began the publication of Imago in 1912 (Hel- 
ler, Vienna). It is bi-monthly edited by O. Rank and H. Sachs. 
Among many stirnulating and valuable papers there appear ex- 
tensive bibliographies (Vol. I, p. 91, Vol. II, pp. 97, 609) of the 
studies on the application of psychoanalysis to the mental sciences, 
chiefly on Individual Psychology, Sexual Psychology, Dream' Psy- 
chology, Occult Psychology, Child Psychology, Pedagogy, Biog- 
raphy, Esthetics, Mythology, Philology, Religion, and Crim- 
inology. These bibhographies are available to the end of 191 3. 

In January, 19 13, the Internationale Zeitschrift fur Aerztliche 
Psychoanalyse v^as founded by Freud with Drs. S. Ferenczi and 
O. Rank as editors as the official organ of the International Psy- 
choanalytic Society ( Heller, Vienna ) . It is a bi-monthly and covers 
the same ground as the Zentralblatt, which latter has discontinued 
publication.^ A. Adler and C. Furtmiiller founded the Zeitschrift 
filr individual Psychologic (Reinhardt, Munich) in 19 13 which 
contains psychoanalytic material. In the Journal of Abnormal 
Psychology (Badger, Boston), psychoanalytic material will also 
be found. 

The only journal in English is the Psychoanalytic Review 
(Nervous and Mental Disease Publishing Co., Washington) 
which aims to be catholic in its tendencies, a faithful mirror of 
the psychoanalytic movement, and to represent no schisms or 
schools but a free forum for all. It is now entering its fifth year 
and contains original articles and very extensive and complete ab- 
stracts of all of the periodical literature. 

The Journal of Nervous and Mental Disease, and the Nervous 
and Mental Disease Monograph Series have also contributed sev- 
eral psychoanalytic studies. The most important of these in addi- 
tion to those already mentioned are the translations of Jung's 
Psychology of Dementia Prcecox, Bleuler's Schizophrenic Nega^ 
tivism, a short but highly suggestive study, Abraham's Dreams 
and Myths, No. 15, Rank's Myth of the Birth of the Hero, No. 
18, and Riklin's Wish Fulfillment and Symbolism in Fairy Tales, 
No. 21. The History of the Psychoanalytic Movement by Freud, 
No. 24: Silberer's Problems of Mysticism and its Symbolism, 
Translated by Jellifife. 

With these sources the beginner will be able to put himself in 
touch with the current literature on any problem. Special bibli- 
ographies will appear in these pages from time to time. 
5 Discontinued October, 1914. 



HISTORY OF PSYCHOANALYSIS 



27 



Since these pages appeared in serial form a number of addi- 
tional works have appeared to which attention should be drawn. 
One of the most satisfying is White's " Mechanisms of Character 
Formation," Macmillan Co., 1916. Wilfrid Lay has also written 
an excellent small work, entitled " Man's Unconscious Conflict," 
Dodd Mead & Co. This will be found useful to the lay reader 
who is desirous of learning of the general principles of psycho- 
analysis. Dr. I. Coriat has written a primer of psychoanalysis 
under the title " What is Psychoanalysis ? " in a series of ques- 
tions and answers. It is useful for those who need to have def- 
initions made for them in simple and concise form. As a primer 
it is useful. E. B. Holt's The Freudian Wish is a valuable work 
from the psychological school. 

Complete or abbreviated studies are obtainable in the Psycho- 
analytic Review which presents the entire range of the psycho- 
analytic movement. 



CHAPTER III 

Opening of the Analysis. The General Situation and 
Preliminary Formulations 

The best preparation is a complete analysis by an experienced 
psychoanalyst. This is difficult to obtain since so few physicians 
are willing to give up the time. Continual self analysis is requisite 
during the course of analytic work. The analysis of a resistance 
always shows psychoanalytic scotomata on the part of the analyst. 
It is through the resolving of these unconscious blindspots of his 
own that the analyst is able to free his patient. The would-be 
analyst should work resolutely with his own dreams, if possible 
with the aid of some one versed in psychoanalysis. A few passing 
remarks at a street corner or at a chance meeting are worse than 
useless. 

The Beginnings 

The first meeting with the patient is of great importance. 
One should observe every little sign, for many neurotics have 
" suffered much of many' physicians " and are usually supersensi- 
tive and highly critical. Little occurrences should be carefully 
noted, sudden reddening, twitching of the fingers, tapping of the 
hand or foot, restlessness, looking about, gestures, dryness of the 
mouth, changes in expression, variations in pupils, perseverations, 
repetitions, circumstantiality in narration, apparently irrelevant 
and quick jumps from one subject to another, gaps, mispronunci- 
ations, retardations, and slowness in places. Note carefully, but 
avoid mentioning, small contradictions, also observe over-scrupu- 
lousness in details, attempts to be very precise and exact and all 
small things. They are of importance in psychoanalysis. Adler 
and Freud^ were the first to call attention to the fact that at times 
the very first sentence uttered by the patient contains the clue to 
their whole general situation. The analyst should also recall that 
he is under a close scrutiny as well and should hold himself as 
impassive as possible, yet be appreciative, anxious to learn and gen- 
uinely receptive. Neurotics are for the most part unusually sharp 
and intuitively penetrating. They cannot be deceived very long. 

1 Bemergungen u. e. Fall v. Zwangsneurosen, Jahrhuch, i, p. 366. 

28 



OPENING OF THE ANALYSIS 29 

The patient will usually tell why he or she has come and what 
the symptoms are. If patients come with parents, relatives, etc., 
it is wisest if possible to get the patient's story alone and first. 
At times this is not possible. Often it may be advisable to get 
the parent's story first, when one can say to the patient '' You tell 
me your own story. I have heard what some one else thinks, but 
you are the sick person and your story is what I really wish to 
understand. I wish to learn from you at first hand." The first 
hour should be wisely used to gain as much confidence as pos- 
sible.^ Such confidence is gained largely through the patient ob- 
serving that the analyst is really listening and understanding. For 
patients who have had many physicians this is highly important. 

The history of the development of the difficulty, as the patient 
sees it, is usually a much distorted product, yet it is entitled to first 
place in credence, and it is bad psychoanalysis to attempt to break 
down the patient's attitude towards the disorder and its causes in 
the opening as well as at any time during an analysis. For this 
as well as a number of reasons, the analyst should explain little 
or nothing, least of all attempt to do away with the symptoms by 
explaining them until the entire situation is grasped and the ana- 
lyst has a fairly accurate knowledge of the disorder. 

It is usually impossible to prevent the outpouring of all of the 
symptoms. This freedom of expression is encouraged by some 
analysts, discouraged by others. It is usually true that the symp- 
toms are repeated over and over again and many patients have 
them all written down, in order that they may not forget them. 
'A certain amount of this repetition should not be prevented ; it not 
infrequently contains important variants, yet the analyst soon 
must tell the patient that such a repetition is often beside the ques- 
tion. It is frequently a ruse on the part of the unconscious to divert 
the attention away from the real difficulties. It is as if the physi- 
cian's regard should be constantly directed to let us say, a pitting 
edema of the legs to the neglect of a leaky heart valve. It is like 
the reaction of the flushed partridge that rises many yards away 
from its nest. 

One may take the history systematically, guiding the patient 
along certain points, history of the family, etc., but it is preferable 
to say to the patient, "Tell me all about yourself, and I shall 
listen. If I am not quite clear as to what you mean I shall ask 
you in detail, but tell me everything that comes to your mind." 

2 Stekel, " Nervose Angstzustande." 



30 THE TECHNIQUE OF PSYCHOANALYSIS 

Some patients are reticent, however, under such instructions, and 
may not tell anything. For such, a gradual drawing out is neces- 
sary. One may follow any scheme, but it is often a good one to 
go over more or less systematically the family history, first with 
reference to their diseases, then with reference to the patient's 
relations to his family, his parents, the brothers and sisters, their 
ages, etc. The early relations to teachers, nurses, governesses, 
tutors, etc., is of equal importance. 

The family units must be firmly grasped by the analyst in all 
the small details, for out of these the family neurotic romance 
has been constructed by the patient.^ Herein will be found the 
early character lineaments which later on become the subject 
matter of the analysis. 

It is not over advisable to take up the numerous details of the 
history of the patient chronologically since the emotional develop- 
ment is not arranged by years, yet major events which will serve 
as definite dates in the life history should be jotted down. 

It is a striking fact that most neurotic disorders, using the term 
in its broad sense, have a fairly definite starting point. For the 
most part the patients are able to say just when the symptoms 
began. The exact hour or day must be noted. It is not acci- 
dental. " The trouble began exactly three months ago after the 
death of my mother," says one patient. Another recalls that her 
"fifteenth birthday was forgotten by her parents; she saw her 
physician on the fifth of the month; made an hysterical suicidal 
attempt on the twenty-fifth." Still another tells that she " had a 
bad cold, she had used up all of her handkerchiefs, when she 
used a piece of paper to wipe her nose. It was at this instant 
that she felt that her nose began to grow larger." Another felt 
that " he had a mission in life as he saw that the seat of the Presi- 
dent's daughter in the theater, No. 9, tenth row, corresponded to 
the birthday of his brother, the ninth of October '* [x, 9] . 

As one gathers these histories one finds similar precise details. 
Such should be gone over carefully, as they almost invariably have 
some very definite relationship to the symptomatology of the neu- 
rotic disorder. At times they flash. the diagnostic signal and the 
chief unconscious complex difficulties. 

Great care should be taken to have the patient go over in con- 
siderable detail every little incident of the onset of the difficulty. 

3 Rank, " Myth of the Birth of the Hero," Nervous and Mental Dis- 
ease Monograph Series, No. 18. 



OPENING OF THE ANALYSIS 3I 

One will rarely find an adequate explanation in the usually highly 
rationalized account given by the patient, yet the correct dynamic 
situation is usually contained within it and will stand revealed 
later on in the course of the analysis. It is often by reason of a 
patient's persistent reiteration of a statement that one gets very 
important clues. Thus a patient suffering from an hysterical 
anxiety depression — termed a melancholia — during an hour's con- 
sultation repeated at least half a dozen times " how good her hus- 
band was, how true he was, and how much she loved him." It 
was not at all surprising to hear later of his very open use of 
almost enormous sums of money to keep up an extra marital 
establishment, ostensibly for his " out of town customers." That 
which a patient so frequently asseverates consciously often con- 
ceals a directly opposite unconscious trend. 

A psychoanalytic history differs in many respects from an ordi- 
nary medical history. It is largely built around the patient's story. 
Some analysts have constructed elaborate questionnaires. These 
are often of a great deal of service. Thus Hoch and Amsden 
have published a highly elaborate " Guide to the Descriptive Study 
of the Personality With Special Reference to the Taking of Anam- 
neses of Cases of Psychoses."* 

The personal constitution is difficult to define and schemes of 
this nature are often very useful in indicating to the beginner what 
groups of facts are liable to prove of value. It is for the same 
reason that reference has already been made to the Binet-Simon 
tests as of value in excluding various forms of the feebleminded 
as not being proper subjects for psychoanalysis. Inasmuch as in 
all analytic work great accent falls upon the affective life of the 
individual, the questionnaire of Hoch and Amsden is particularly 
useful since it devotes much attention to the affective reactions 
of the individual. The questionnaire cannot be repeated here, 
only its general features are indicated. I. Traits relating essen- 
tially to the intelligence, the capacity for acquiring knowledge, the 
judgment, etc. II. Traits relating essentially to the output of 
energy. These factors of work and of play are of much value in 
the first survey of the patient, in sizing up his adaptability for 
analysis. III. Traits relating to the subject's estimate of himself. 
IV. Adaptability to the environment: (a) traits which on the ab- 
normal side interfere in a general and striking way with environ- 

* Review of Neurology and Psychiatry, Vol. XI, 1913, p. 577. [Schulze, 
Edinburgh,] 



32 THE TECHNIQUE OF PSYCHOANALYSIS 

mental contacts; (b) traits which in a more specific, but in a less 
obvious way, interfere with contact with the environment; (c) 
traits which show to what extent the subject lays bare to others 
his real self; (d) traits which in normal proportions are useful, 
but which in exaggeration interfere with efficiency; {e) traits 
which show a tendency to active shaping of situations, or the re- 
verse; (/) traits showing attitudes towards reality. V. Mood. 
VI. Instinctive demands, or those traits more or less closely re- 
lated to the sexuality: (a) friendships; {b) attachment to mem- 
bers of the family; (c) attitude towards the sexes, general, spe- 
cific and related thereto, as for instance idiosyncracies, or story 
telHng, niceties, etc. VII. General Interests. VIII. Distinctly 
pathological traits. 

A formal psychognostic appraisal such as this just outlined is 
of great value from a descriptive standpoint. It is almost imper- 
ative in cataloging and classifying human types, but a too strict 
application of it will usually defeat the purpose of a psychoanal- 
ysis. It is of descriptive not therapeutic value, and yet prac- 
tically all of the material must be covered in a psychoanalytic 
history. But it should be reached by a much more casual and 
natural method. 

It being assumed that the patient has had at least two visits 
during which a fairly complete history has been obtained, the next 
step is to determine whether the individual should be analyzed at 
all. A consideration of the types already spoken of should be 
made and if the patient is not to be analyzed, the situation should 
be so stated, if there is any occasion for it. The treatment of 
the patient will then go on on general lines as determined by the 
needs of the case. A neurologist or psychiatrist is not necessarily 
only a psychoanalyst, any more than an internist is committed to 
the exclusive use of quinine for every ailment. 

If it seems that the patient has the right qualifications, and 
has a disorder for which analysis is adapted, it is in general good 
technique to say that as, you see the condition it seems advisable to 
begin a psychoanalytic procedure, but you would prefer to see the 
patient for a week or two weeks, from perhaps five to eight 
times, before you are willing to say exactly what is wrong, what 
can be done, what the program will be, and what it will cost. 
This preliminary program is highly advisable. In the first place, 
it may soon develop that the patient is not analyzable. He comes 
within one of the classes outlined in the previous chapter. He 



OPENING OF THE ANALYSIS 



33 



may not be serious about it, or possess the necessary intelligence. 
There may develop definite social reasons why one analyst should 
not do the work whereas another might. It may be that the neces- 
sary rapport cannot be set up. These patients must not be dangled 
along. One must analyze them or not. There are no half-way 
steps — unless one is open and frank about it and not call bumble- 
puppy an analysis. The critics of psychoanalysis are mostly re- 
cruited from this group of patients who coming a few times are 
usually told that they are not wanted. They say many evil things 
of the physician. Or it may develop that the patient is an incip- 
ient schizophrenic, or, utilizing Kraepelin's conception, a para- 
phrenic. Should the diagnosis of schizophrenia develop out of the 
preliminary treatment, and it often takes longer than two weeks 
to feel out a schizophrenic or an hysterial trend, it becomes a 
question of judgment whether to attempt an analysis. For my- 
self, I have seen a great many early schizophrenics. It has been 
my custom to tell the parents or friends that I consider the illness 
very grave, and that it is as yet an open question whether psycho- 
analytic procedures will prove of any service. So much is known, 
however, that no other mode of approach has even offered any 
attempt at an understanding of what is going on in the patient's 
mind. The results are problematical. One will do all that one 
can do, accept the responsibility, but make no promise of curing 
the patient. One is in the same situation as an internist with a 
typhoid, or as a surgeon with a fairly diffuse carcinomatous proc- 
ess. Only the charalatan promises a cure under such circum- 
stances. Special problems arising from special groups will de- 
velop later in these pages. 

The preliminary work of treatment should begin as a real psy- 
choanalysis, but the analyst will have said very little to the patient 
about the general scheme, or what he is attempting to do, beyond 
asking the patient to do most of the talking, and entering into the 
proper unfolding of the unconscious only as it comes up. It is 
frequently of service to get a dream or dreams which have been 
dreamed before coming for treatment and it is of much value in 
guiding one's self, to obtain the first dream that the patient has 
after starting treatment. No special stress should be laid upon 
these in the beginning, but they should be written down, and put 
aside for future reference. 

A great many patients who are in need of psychoanalysis can- 
not afford it. It seems costly to the patient, while not partic- 



34 THE TECHNIQUE OF PSYCHOANALYSIS 

ularly remunerative to the analyst, because of the great amount of 
time necessary. It is not only this however which makes it neces- 
sary to get the money question out of the way, but it is as Freud 
has well pointed out^ that money as a complex is as difficult 
to deal with as sexuality. It follows the same general trends and 
needs to be handled openly and frankly. The analyst asks con- 
cerning the patient's circumstances and makes his agreement. 
Inasmuch as one will see the patient four or five times a week, 
sometimes daily, excluding Sunday, many patients prefer tO' pay a 
monthly amount. This usually settles all questions, conscious or 
unconscious, as to the cost of such treatment. 

It is highly undesirable to treat patients for nothing. Strong 
transferences are set up which interfere with the getting well 
of the patient. 

Naturally the patient desires to know how long it will take. 
On this point one cannot be positive as so much depends on what 
develops in the treatment. One can in general say that patients 
who really need a psychoanalysis — who are not indulging in a 
luxury so to speak — need at least two to three months treatment. 
Most severe hysterias need from five to eight months, and patients 
with compulsion neuroses usually need more time. One can often 
aid a compulsion neurosis to such an extent that they are very 
much relieved after four or five months or even in a shorter time, 
but to cure them takes often a year, or more. . Naturally there 
are some patients who cannot be cured. They will not be cured. 

Patients themselves will vary a great deal. At times they 
even continue to be sick longer than seems necessary, as will later 
be developed. This is a problem of a sornewhat mismanaged 
transference. In general it is often helpful to work for a definite 
point. The goal is to be reached in a certain time. 

It is by no means infrequent that the analyst will be expected 
to work marvels. All new movements in medicine have their 
" wonder periods " and patients who have been sick ten, fifteen, 
twenty years, have visited literally hundreds of physicians and 
spent all of their own and other people's means, expect to be made 
well by coming into an analyst's office. Psychoanalysis has fe- 
solved some very obstinate cases, but it is not yet in the miracle 
working category. 

^"Weitere Ratschlage zur Technik der 'Psycho3.n2ilyse," Inf. Zeitschrift 
f. Psa., I, 1913, p. I. See p. 225, Psychoanalytic Review, Vol. i, No. 2. 



OPENING OF THE ANALYSIS 



35 



In reviewing the very large literature which has appeared up 
to the present time (over a thousand titles) it may readily be 
seen that the claims made by those who have been practicing 
psychoanalysis have been very conservative, — in fact, such con- 
servatism appears in inverse ratio to the vituperation heaped upon 
the psychoanalyst and the analytical methods by stupid critics. 

It is important to tell the patient not to discuss the question 
with any one until they have had enough experience to do so 
intelligently, — when of their own accord they have it borne in 
upon them that it is usually hopeless to attempt to make those 
who do not wish to see any the wiser. The would-be critic is 
usually in the position of one who, unable to decipher his own 
Chinese laundry check, immediately feels competent to discuss 
the whole subject of Oriental languages, history and culture. 

It is very rare that one is not expected to give some explana- 
tion of what one is going to do : This calls for some form of 
preliminar}^ statement. No two individuals can be approached 
in the same way, but it is not bad technique to tell the patient, 
after the general history may have begun, that the chief work of 
analysis is to enable the patient to see his or her unconscious. 
That it is in this form of mental activity that the chief causes for 
the disturbances will be found. This will probably lead to an 
inquiry as to " what is the unconscious ? " The unconscious is 
after all a way of looking at things — an hypothesis like all other 
mental concepts — and it will vary with each analyst's previous 
training, and each patient's intellectual status as to how the idea 
can be developed.^ 

White has well said that the unconscious is our historical past. 
Bergson's idea of the unconscious is often a useful one to use. 
He states it somewhat as follows 'J " For our duration is not 
merely one instant replacing another; if it were there would 
never be anything but the present — no prolonging of the past into 
the actual, no evolution, no concrete duration. Duration is the 
continuous progress of the past, which gnaws into the future, and 
which swells as it advances. And as the past grows without 
ceasing, so also there is no limit to its preservation. Memory 
is not a faculty of putting away recollections in a drawer or of 

6 See White : The Unconscious, Vol. 2, No. i, Psychoanalytic Review. 
Review. 

7 Bergson : Creative Evolution. Tr. by Mitchell. H. Holt Co., N. Y., 
191 1. An important work for psychoanalytic insight. 



36 THE TECHNIQUE OF PSYCHOANALYSIS 

inscribing them in a register. There is no regisl^er, no drawer, 
there is not even, properly speaking, a faculty, for a faculty works 
intermittently, when it will or when it can, whilst the piling up of 
the past upon the past goes on without relaxation. In reality, 
the past is preserved by itself automatically. In its entirety, 
probably, it follows us at every instant; all that we have felt, 
thought, and willed from our earliest infancy is there, leaning 
over the present which is about to join it, pressing against the 
portals of consciousness that would fain leave it outside." 
^ And then follows a masterly sentence which epitomizes a very 
important aspect of the Freudian doctrine of the unconscious 
which is followed by an extremely clever formula, which can be 
applied to the entire psychology of the unconscious. Coming as 
it does from an entirely different source and from a different 
angle it is worth calling special attention to and to advise the 
young analyst to " get it." " The cerebral mechanism is arranged 
just so as to drive back into the unconscious almost the whole of 
this past, and to admit beyond the threshold only that which can 
cast light on the present situation or further the action now being 
prepared — in short, only that which can give useful work. At 
the most, a few superfluous recollections may succeed in smug- 
gling themselves through the half-open door. These memories, 
messengers from the unconscious, remind us dimly of what we 
are dragging behind us unawares." Herein may be seen the 
Bergsonian formula, which Freud has so well analyzed, and to 
which the latter applies the concept, mismanaged repressions, 
which, smuggling themselves through the half-open door, become 
modified in ways to be discussed later, and show themselves as 
the "symptoms" of the neurosis. , 

Many a wise aphorism has touched upon this situation for 
what is called the normal, among them that of Rochefoucauld 
who says, " There is no vice that is not better than the means we 
take to conceal it." But we are not through with Bergson. He 
continues, " But even though we may have no distinct idea of it, 
we feel vaguely that our past remains present to us. What are 
we in fact, what is our character, if not the condensation of the 
history we have lived from our birth, — nay even before our birth, 
since we bring with us prenatal dispositions? Doubtless we 
think with only a small part of our past, but it is with our entire 
past, including the original bent of our soul, that we desire, will, 
and act. Our past, then, as ,a whole, is made manifest to us in its 



OPENING OF THE ANALYSIS 37 

impulse; it is felt in the form of tendency, although a small part 
of it only is known in the form of the idea." ^^ 

Lyell, in his celebrated essay on the antiquity of man, carried 
human beings back many thousands of years as to their origin, 
but the psychoanalyst teaches that the unconscious started much 
further back than the coming of man, and really the " tendency," 
the " impulse " began with the coming of life itself. This was many 
millions of years ago. In building up the notion, therefore^ of 
the unconscious for the patient it must be emphasized that human 
beings have not come to be what they are according to the con- 
ception of Topsy, who " specks she jus' growed up," but that for 
many, many million years the piling up of the past upon the past 
has resulted in this the last and most highly complicated model- 
man, — which analysis seeks to partially pick apart to see what is 
not going advantageously, i. e., not doing useful work. ^ 

In my own discussions of this problem I have found it advan- 
tageous to impress upon patients the immense importance of this 
time element in the slow elaboration of instinctive reactions, 
which are so highly conservative and protective, and I insist upon 
the fact that the neurosis is in line with the whole process. It 
also is a bit of conservation, — something compensatory and pro- 
tective, and I call to the attention of such patients similar mechan- 
isms in the life activities of lower levels of the body. Hyper- 
trophies compensate for some insufficiency. Rapid breathing 
in pneumonia, for instance, compensates for diminished lung 
capacity, etc. 

In further explanation of the scheme I picture to the patient 
three periods of growth : From conception to birth ; from birth to 
five years of age; and from five years to adulthood. Each of 
these represents a wonderfully elaborate scheme of reliving the 
past, through a masterful recapitulation. The nine (9) months, 
forty (40) weeks, two hundred and eighty (280) days of preg- 
nancy (these numbers are here accented as it will be seen how 
constantly they come up in symbolisms of all kinds) reenact all 
of the successful experiments of over a hundred million years. 
The babe at birth already has more than it shall ever acquire. 
It is a complete machine for self running. It has practically 
completed its biochemical machinery. Its entire vegetative 
neurological mechanisms are integrated and functioning. It is 
ready to pass into the realm of feeling. It is to know pleasure 
and pain, and to build up a sense of the ego. Heretofore it has 

4 



3,8 THE TECHNIQUE OF PSYCHOANALYSIS 

led a purely vegetative existence; all of its needs have been at- 
tended to within the mother. From the standpoint of individual 
effort it has been omnipotently indolent. From the organic 
memory of this stage of the child's existence probably comes the 
truth of Rochefoucauld's celebrated saying : " Indolence is the 
most sublime and the most malign of all passions." All of the 
prenatal influences are laid down; the hereditary, constitutional 
factors, which eugenic studies are analyzing, are all there. All 
of Adler's constitutional inferiorities are there. This is a period 
usually thought of by students of mental phenomena as of the 
least importance, but from the standpoint of the unconscious, and 
for the purposes of instinct analysis, it may readily be seen that 
it is a period of great importance, although maybe it escapes, 
and will for some time, most attempts to be analyzed. Most of 
our medicine at the present day occupies itself with the considera- 
tion and study of this, the biochemical, level, the simplest level 
of the human organism. We shall see that hysterical conver- 
sions, compulsion substitutions and psychotic projections can 
create definite disturbances in the functionings of this level. The 
great loss of weight in the depressions with marked eosinophilia 
being only one of many examples, to which attention may be called. 

With birth the new element of an enormous branching out of 
the sen.sori-motor mechanisms takes place, and from this time on 
to, arbitrarily say five, a new recapitulation period is traversed. 
This time the path is shorter ; from anthropoidal ape let us say to 
man of the agricultural period — or highest savage. This is a 
living over of some several hundred thousand years.^ It passes 
through the period of the development of ego consciousness; it 
develops through the phantasy of pleasure-pain to reality and to 
the beginning of social consciousness. This is the period of the 
polymorphous perverse of Freud. This is the most important 
training period of the child. It is the period during which he 
will gradually thrust into his unconscious much of the repressed 
material which analysis will be called upon to interpret. 

From whence comes this repressed material upon which the 
Freudian hypotheses lay so much stress, and which seems such 
an anathema to those who do not care to see that psychoanalysis 
contains a constructive program? Psychosynthesis takes place 
coincidently with psychoanalysis, and man, after all, is the 
measure of all things. Psychoanalysis deals with factors of 

s Compare E. Smith : Age of Man, Smithsonian Reports, 1912. 



OPENING OF THE ANALYSIS 39 

human experience simply as facts. What a fact is will be left 
aside for the moment, save that as Protagoras has well said, we 
build up our truths as we perceive them, each for himself, and , 
each differently. We think alike, i. e., "we agree concerning 
those things it is necessary to agree about in order to live at all ; 
we vary concerning the things which are not neded for bare exist- 
ence, even though they may conduce to a Hfe that is beautiful 
and good. But it is only zvhen we do not act at all that we are 
able to live our own private life apart, and to differ utterly from 
all others r^ 

It is this desire to " differ utterly from all others " that has to 
be brought into line with the facts of reality. This period of 
infancy is the one during which this conformity to sense experi- 
ence must take place if the child is to live at all. Here "im- 
pulse" makes reaching out a constant exercise, with increased 
activity if pleasure is obtained, and withdrawal if pain results. 

Already the biochemical levels have evolved their tropisms; 
action and reaction are going on automatically through the media- 
tion of the vegetative nervous system. The anatomical struc- 
tures which subserve these functions need not now concern us, 
but it is assumed that the psychoanalyst has some fundam^ental 
knowledge of the nervous system; without it he will never rise 
to the highest levels in psychoanalysis.^^ 

But the child has now passed into the realm of more com- 
plete sense experience. A further evolution of what ultimately 
will be handled as consciousness has commenced; many million 
receptors, sensory receiving organs (six million in the eye alone), 
suddenly commence to have energy thrust upon them, which has 
to be handled. Each group of receptors builds up values for 
itself and for the purpose of its own cell groups. At first there 
is a marked rivalry among the sensory areas, which through re- 
pression later develop coordinations between the various strivings. 

9 Dialogues of Protagoras. See F. C. W. Schiller, Studies in Human- 
ism, Macmillan. An excellent picture of dementia prsecox. 

10 For a full discussion of the anatomy and functions of the vegetative 
nervous system consult Higier, Monograph Series, No. 27, also English 
text-books of the physiology of the vegetative nervous system. See Eppin- 
ger and Hess, "Vagotonia, A Clinical Study in Vegetative Neurology," 
Nervous and Mental Disease Monograph Series, No. 20; Cannon, "Bodily 
Changes in Pain, Hunger, Fear and Rage," D. Appleton & Co. ; Falta, " The 
Ductless Glands," Blakiston. 



40 



THE TECHNIQUE OF PSYCHOANALYSIS 



To illustrate this early developmental phase of energy rivalry 
I have often made use of a diagram which I here reproduce in 
the rough. 

This diagram is meant to illustrate only in a general manner 
the initial distribution of the sensory areas, which through evolu- 



Nutritlve Skin Structures Pelvic Species Senses 




Original Fetal Libido Values. 



This illustration is purely diagrammatic. It aims to show the first 
steps in libido distribution following birth. Each and every libido area 
here represented is a compound which analysis endeavors to resolve. 



tion, in response to the principle of pleasure and pain, will ulti- 
mately permit of the chief forms of energy distribution which we 
call human conduct. The world and its values will be built up 
by the child through these sensory channels. 

At birth the entire energy is concentrated on the respiratory 
act. One hundred per cent., one might say, of the child's striving 
is expressed in the first cry made in response to the organic need 
for oxidation (biochemical level). The respiratory nucleus 
starts its reflex activities and the human mechanism is now work- 
ing independently. 

It is at this point that Freud introduces a new term, libido. 
In this particular instance it signifies the energy of seeking for 
the organic satisfaction of oxidation activities. Respiratory 
libido, therefore, constitutes the first libido striving of the child. 
Crying brings its satisfaction, therefore, crying becomes an initial 
symbolic act through which desire, i. e., a renewal of the pleasure, 
will be satisfied. 



OPENING OF THE ANALYSIS 4I 

I need only call attention here in passing to the marvellous 
evolution which this respiratory libido undergoes, and which as 
one of its chief end-products is the complex human speech. 
Originally, a broad, explosive, non-discriminative cry, a vast con- 
glomerate, the respiratory libido develops little by little an intri- 
cate mechanism of highly discriminative acts (speech) of the rich- 
est symbolic significance. 

The gastro-intestinal libido now clamors for its instinctive 
(biochemical) satisfactions. The skin must be kept warm (re- 
producing the amniotic water bath) else the same vigorous 
protest, as yet non-discriminative, will howl for skin libido satis- 
faction. Through the combined action of rolling neck motions 
and smell the nipple is found, and purposeful sucking movements 
begin, until the incoming stimuli, esophageal, gastric, — through 
chemical receptors, mount up to a fatigue threshold and sleep 
intervenes. 

Then follow other organic need satisfactions ; pleasure is ob- 
tained by doing things essential to life. The bladder is emptied, 
the bowels are evacuated, the eyes look about, the ears hear, 
etc. The important factor to be recognized and insisted upon is 
that in the initial phases each libido area is egoistic, self-seeking 
to the exclusion of all others; the child stops breathing in the 
early attempts at feeding : all other forms of libido energy wait in 
abeyance until that one demanding the moment satisfaction is 
appeased. 

It may be recalled that many years ago, Hansemann, a present 
professor of pathology in Berlin, spoke of " die Anaplasie, die 
Individualitat und der Altruismus der Zellen." He tried to show 
then how a failure on the part of the cell striving (biochemical 
level) produced various developmental failures in this or that 
organ of the body ; that even before birth a principle of anarchy 
among the organs of the body might prevail, and that the best 
organisms were those in which the subordination of the claims of 
one cell group (liver, kidney, lung) to the others, was best 
practiced. 

After birth, a similar adjustment in libido values at the sen- 
sori-motor level is necessary, and here is where repression com- 
mences to be operative. In terms of conscious psychology the 
process by which this repression is in part furthered is called 
training or education. 

The chief sensori-motor corrective is pain. Later we shall see 



42 THE TECHNIQUE OF PSYCHOANALYSIS 

that at psychical levels we shall call it fear. Wherever fear com- 
mences to enter, then the training for social values commences to 
be manifest. It becomes the corrective for desire. 

Positive and negative tropisms, pleasure and pain, desire and 
fear, these are the chief stages in this evolutionary progression 
vv^hich ultimately brings about adjustment of conduct at highest 
social values ; at ultimate pragmatic realities ; i. e., those lines of 
conduct, which under experimental conditions will permit the best 
suited individual and the best group to continue to survive. 

Repression, therefore, consists in the subordination of cer- 
tain libido values at lower levels in order that a utilization of 
identically the same energy may take place at higher levels in the 
process termed sublimation. 

In the infantile period, the pleasure principle seeks the con- 
tinuance of the satisfaction. The term, erotic satisfaction, is 
used by Freud to signify this in the general sense, by whix:h is 
meant the gratification of the pleasure sense of the area involved. 
Thus, there can be respiratory, lip, stomach, urethral, anal, skin, 
retinal, cochlear, vestibular, muscular, gustatory, and olfactory 
eroticism. To assume that only one area of the body is capable 
of receiving sense gratification, and hence that the word, auto- 
erotism, has reference only to one area, ^*. e., the genital area, is 
unutterably stupid, and yet this is the usual implication given to 
the word by critics. There is ample justification for applying the 
term, auto-erotic, to each receptor group already indicated, since 
it has been seen how the interest (libido) may be transferred 
from one area to another that becomes the center of striving. 
The very structure of the nervous system through its synaptic 
integrations shows just how this switching can take place, and 
CajaFs ingenious hypothesis of avalanche action enables one to 
see how summations of energy can occur, so that cumulative 
effects may result. The study of the repressions in the develop- 
ing psyche shows that these follow precisely similar laws to 
those which physiologists are working with in reflex block- 
ings, etc.^^ 

It is because in the early stages of the infant, each libido area 
seeks its own satisfactions in interchangeable fashion and any- 
thing stands for anything without discrimination, that Freud has 
used the term, polymorphous perverse. The child has no con- 
sciousness of any perverseness : There is no perverseness at this 

1^ See Kempf, Psychoanalytic Review, Vol. 2, No. 2, 1915. 



OPENING OF THE ANALYSIS 43 

period. One can only say there is an eager seeking for richness 
of sensory satisfaction, and an active exploration of every source 
of joy and gratification ; but, and here reality commences to assert 
itself, if such seeking is continued at its primitive values, pain, 
fear, reproach and finally exclusion from the herd result. For 
if certain of these activities continue into adult life one may speak 
of them as perverse. Perversion is the conscious end of a long 
chain of links in which unconscious, auto-erotic satisfaction, i. e., 
pleasure gratification of an area, is a predecessor and the origin 
of which is the very life impulse itself. 

Steckel has used the phrase, "infantile criminal," to express 
this same period of the infantile development. The analyst 
should bear in mind both of these expressions, "infantile per- 
versions" and "infantile criminal," but he should not voice them. 
It does very little service in the initial stages of an analysis to 
tell the patient about his " perverse " or " criminal " tendencies. 
He will not understand, because in the early stages of analysis 
the patient is constantly thinking in conscious terms. He is. as 
yet unacquainted with unconscious logic. It is only when the 
significance of unconscious activities get firmly fixed in the 
patient's mind that the analyst can utilize these terms to ad- 
vantage. For this reason, and also because perhaps it represents 
a better mode of approach, it has been my habit to dwell less 
upon the " perversion "'and more upon the' evolution of the sense 
of power that goes on in the patient as he builds up values on the 
basis of his primary pleasure-receiving areas. After all the 
infantile criminal is only seeking for an expression of power. 
He is not a criminal until that power impulse forces him to a 
conflict with reality. 

The striving for power is the mo'st important symbol to keep 
in mind, because it will be seen that practically all the symboliza- 
tions which are pictured by the unconscious are being utilized in 
this way. Protagoras in the dialogue already quoted said that 
"we think alike concerning those things which are necessary for 
life." He is speaking of conscious thinking. This uniformity in 
unconscious impulse is even more striking. Inasmuch as breath- 
ing has satisfied oxygen needs, which oxygen-need satisfaction 
enables the body to Hve, breathing and all of the necessary 
muscular adaptations (respiratory libido in the psychoanalytic 
sense) become symbols of obtaining power in the psyche. Be- 



44 THE TECHNIQUE OF PSYCHOANALYSIS 

cause the muscular adaptations for expulsion of the urine from 
the bladder succeed in keeping the individual alive, therefore 
these muscular adaptations (bladder erotic, bladder libido} also 
become symbols of power. Similarly, the need for the expul- 
sion of wind or the expulsion of feces from the intestines may 
become an expression of power in unconscious symbolization. 
These acts are all necessary for living. Ergo they represent 
power. In psychoanalytic terms they represent the several partial 
libido, trends. Each trend has its own king and kingdom. It is 
only when one king strives to usurp the rights of all the others 
that we can apply the term " perverse " or " infantile criminal." 

Analysis, therefore, is to he utilised to trace the evolution of 
the individual from these infantile sources of power belief, or as 
we have already expressed it, to reconstruct the pattern of these 
partial libidos or partial strivings in their building up of the 
combined libido, which determines the individual's conduct. 

Each and every one of these partial strivings must contain a 
portion of its initial energy concentrated on the primitive exhibi- 
tion of its power. 

It always remains necessary for the bladder to act, as well as 
the rectum, as well as all of the other parts of the body, and 
effectually — ^but in the gradual synthesis of the individual as a 
whole, and more particularly in his adaptation to society as a 
whole, the partial libidos, or the sense of power resident in an 
organic satisfaction must be able to be withdrawn from the area 
involved and concentrated upon some other object, which other 
object, from the standpoint of the evolution of social conscious- 
ness, means the adaptation of the individual to his surroundings 
i. e., to reality. The mode by which these changes of direction 
of the libido take place is the central problem of what is 
designated repression. Repression therefore has for its function 
the locking up of energy — of libido — until such time as it may 
be used at a higher i. e., socially permitted level. It serves as a 
basis for phantasy. 

It cannot be too strongly insisted upon that this process of 
repression is going on all the time below the levels of conscious- 
ness in the developing child; and that by the age of five, which 
age limit as has already been expressed is purely arbitrary, the 
work of repression, so far as these primitive ego strivings are 
concerned, has resulted in creating a social animal. That is, 



OPENING OF THE ANALYSIS 



45 



antisocial trends can be satisfied in fantasy, rather than in reality. 
As Heraclitus has well said of the night dream, "Is it not because 
we lie still and do not act, that we can indulge our fancy?" 

We shall see that the main work of analysis will ultimately 
center about the way in which the individual in his evolved 
actions, that is to say in his everyday conduct, still endeavors 
to follow out in an infantile manner, this fantasy method of ob- 
taining power, i. e., satisfaction. To illustrate — it should be re- 
membered that illustrations in the early part of an exposition 
of this kind are rather dangerous, just as too comprehensive an 
explanation of the unconscious mechanisms given to the patient 
is disadvantageous in the beginning of an analysis. A certain 
patient was discussing with me, after four or five months of 
analysis, the reasons why she persistently wore certain colors. 
Several dreams had revealed the infantile method of obtaining 
power chiefly through what we shall later discuss under the head- 
ing of the "prostitution phantasy." In the actual discussion of 
the prostitution fantasy it was brought out how for centuries the 
social organism has endeavored to exclude the actual prostitute as 
dangerous. In the illustration I was further called upon to 
elaborate upon the various disguises which unconscious prostitu- 
tion had elaborated in higher and lower walks of life, and 
various trends were shown illustrating the various ingenious 
protective devices by which the high grade prostitute, so to 
speak, was still excluded from the social group in many subtle 
ways. This led to the statement on the part of the patient, that 
she failed to see wherein she was excluded in any way because of 
her unconscious fantasy. We were not dealing in any sense 
with conscious prostitution nor conscious exclusion (I need 
hardly add that the patient was of the highest social and ethical 
development), but we were directing our attention to the analysis 
of the color sensations (eye erotic) as a means for obtaining 
power and were endeavoring to show how, by the evolution of 
color sensation satisfactions, as shown in dress, this particular 
individual strove unconsciously for a sense of power. She strove 
not to be excluded from the attention of the community. In other 
words she utilized very striking colors to force herself upon the 
attention of her surroundings. The unconscious made sure that 
no one would fail to notice her. This we saw, in the discussion, 
was an unconscious attempt to insure the sense of power, which 



46 THE TECHNIQUE OF PSYCHOANALYSIS 

because of the likewise unconscious prostitution phantasy had re- 
sulted in a loss of power (i. e., unconscious sense of exclusion). 
The development of the color sense and the striking use of certain 
color combinations was therefore a protest on the part of the 
individual against the unexpressed and unconscious will of the 
community (reality principle of Freud), and the analysis resulted 
in showing to the patient how in her infantile period of develop- 
ment she had associated certain colors as representatives of the 
expression of power. We shall return to this later in the dis- 
cussion of the dream. 

Before dismissing the illustration entirely, however, I shall 
suggest that the use of " brown " by this particular patient was 
her present day esthetic evolution, which in the infantile one-to- 
iive-year-old period had its origin in a fecal fantasy. The 
analysis was able to show step by step the evolution from the 
infantile sense of power obtained through the gastro-intestinal 
satisfactions to the present day use of a certain color. 
^ When the patient thoroughly comprehends what one means 
by the libido, which is attached to the various parts of the body, 
just referred to; when there is conviction that practically all 
of our present activities have originated from these primitive 
sources, the next point to take up is the tracing of the mechanisms 
by which the present evolutions have come to be. In other 
words they are ready to ask if there are any guiding principles 
which will enable them to trace the pathway taken in the evolution 
of these infantile libido strivings? 

This part of the outlining of the principles of psychoanalysis 
is not so difficult for the patient to comprehend, nor is one liable 
to be met with any opposition, because there is very little dif- 
ference of opinion among educated people that the chief goal of 
living may be reduced to the carrying out of two principles, i. e., 
that of self .preservation and of race perpetuation. There may 
be some difficulty in showing the individual that notwithstand- 
ing our firmly grounded belief that these are the two important 
principles underlying all manifestations of conduct, that there is 
a very definite conflict between them going on in the individual, 
and it also becomes an extremely fascinating part of the psycho- 
analytic doctrine to develop how the male and female act some- 
what differently in this unconscious controversy. 

For purposes of illustration, one can, in thought, carry oneself 



OPENING OF THE ANALYSIS 47 

back many millions of years, when one might say it was decided 
which principle should obtain the ascendancy, i. e., that of self- 
preservation or that of race perpetuation ; whether the individual 
should live for himself alone, or whether in the language of the 
Scriptures "he who would gain his life must lose it." In other 
words individual death was conquered by the process of repro- 
duction. Immortality was gained by sacrifice. Biologists can 
explain why it is that the individual cell could not keep on 
growing indefinitely; that if life was to survive in any organic 
form, it could not do so solely by getting bigger. Notwith- 
standing all the expediencies that an organic thing could build 
up, so that the food supply would be carried to all parts of the 
organism, bigness as a principle reached its limit. Bigness was 
not the principle which would insure perpetuation. The geolo- 
gist, who looks back over the record of the earth's long- career, 
sees rise before him pictures of enormous animals and enor- 
mous plants. Size, however, as a form of power, gave way to 
other principles. In the sea today there float enormous Lami- 
narias, single-celled plants, hundreds of feet long. They are mute 
survivals of an old biological principle ; but it was not through 
this principle of " individuality " that the higher forms of life, 
came to be. The principle of individual loss, or death, was only 
overcome by the principle of reproduction, and hence one may 
reason that of the two principles, i. e., self-preservation or race 
perpetuation, speaking from the unconscious point of view, that 
of race perpetuation was much more imperative than that of self 
preservation, and it conquered. 

In the course of analysis this conflict between self-satisfac- 
tion, from a purely auto-erotic infantile point of view, and the 
larger one of race perpetuation, is constantly being presented. 
Auto-erotic symbolizations, be they epileptic fits, tics, hysterical 
conversions, or what not, are often the outward signs of the 
struggle and the effort to adjust these antagonistic claims. 

Having settled this question for a patient, as to the meaning 
of these two principles, especially in their unconscious bearings 
rather than in their conscious ones, it now becomes important 
to show, or to trace how each principle is handled by each libido 
striving, or each partial libido trend; because it is highly im- 
portant to have in mind that these partial trends are constantly 
working with both of these principles. For the sake of illustra- 
tion let me put it in the form of questions. How does respira- 



48 • THE TECHNIQUE OF PSYCHOANALYSIS 

tory libido handle the food question? How does skin libido 
handle the problem of feeding? How is hunger satisfied by the 
urethral libido? Wherein does muscular libido obtain its nu- 
tritive gratification, etc. ? If each striving had its own way, the 
child would not live, because after all only one libido area re- 
ceives any actual power (satisfaction) from food, i. e., the gastro- 
intestinal, speaking broadly. Auto-erotic satisfaction in the 
other areas must be repressed, and their individual libidos ex- 
pressed in an attempt to obtain food through a transfer of their 
striving to some other area. Thus eye libido must learn that 
such and such an object is food; the muscle libido must be 
trained to know that such and such movements will obtain food ; 
the ear libido must bend its energies to bargaining or to forms 
of adaptations that will make the others adaptive. If in the 
course of bargaining, for instance, there is urgent need for 
bladder or other form of auto-erotic satisfaction, the same must 
be suppressed for the main goal, and the gastro-intestinal power 
symbol satisfied. 

The analysis of the various modes of repression of partial 
libido trends to bring about an adaptation to the self-preserva- 
tion combined libido is very incomplete in psychoanalytic litera- 
ture. Much attention has been devoted to what we have already 
seen is really the more important "of the combined libido trends, 
i. e., race perpetuation or what might more narrowly be termed 
the sexual impulse. It is for this reason that one should pay 
particular attention to the development of the idea of the nutri- 
tive instinct in man, notwithstanding its secondary importance, 
for a great many of the resistances concerning money lie in this 
field. 

We have therefore chosen to pass immediately to the con- 
sideration of the mode of analysis of the reproductive instinct. 
The first formulation of general principles here is what has 
been termed by Freud, the CEdipus Complex. 



CHAPTER IV \ 

The QEdipus Hypothesis as a Psychological Measuring 
Unit. Its Evolution and Final Stabilization 
' AS A Social Force 

It has been my experience to be frequently asked by physi- 
cians, "What do you mean by the CEdipus Complex?" For a 
long time I was unable to answer the question, largely because 
it was asked in jest, but further by reason of the fact that it 
was impossible for me to phrase a reply in a way which I felt 
would be satisfactory to my questioner. When asked partly 
in jest I would frequently reply, "What is the Ehrlich side- 
chain theory ? " This is an apparent evasion. To others I have 
said, " It is a mode of explaining why any individual finds it 
difficult to break away from old ways of doing things in order to 
acquire new and better ones." Again to others, my reply has 
been, " It is a restatement of the world-old struggle of conserva- 
tism versus progressivism." Such a method of handling what 
Freud has termed the "root-complex" of the neurosis will 
hardly suffice. Yet after all the answers just enumerated may 
be found satisfactory if elaborated. 

In the first place the CEdipus Complex is solely an hypothesis, 
just as the Ehrlich side-chain theory is an hypothesis. It is a 
formulation to be used to handle the facts. Instead of terming 
it only the "root-complex" of the neurosis, however, I purpose 
giving it a much broader basis. It can be used as a unit of 
measurement for all psychological situations, not only for those 
" variations which are only perceived when they become great or 
inconvenient," and hence called abnormal, but for every so-called 
normal psychical activity as well. Even the tyro in science knows 
that the idea " normal " is a pure bugaboo. Normal means average 
if it means anything. 

Just as we use a foot-rule to measure all space relations; a 
unit of time for all time relations, so the CEdipus hypothesis can 
be used as a unit for the comprehending of psychical situations. 
It is the only unit which has proved itself valid for all psychical 
phenomena, be they what intellectualists call normal or abnormal. 

49 



50 THE TECHNIQUE OF PSYCHOANALYSIS 

I think I may say that practically every philosophical hypothesis, 
save pragmatism, has neglected what are called pathological 
data, overlooking the fact that pathological does not mean of a 
different, qualitative, nature, but simply a variant which must 
be measured by the same standards as that which is called normal. 

In this connection one may again turn to that ancient sophist 
Protagoras for the first statement of a sound pragmatism. In 
his dialogue with Morosophus on the perception of truth, Prota- 
goras closes an eloquent peroration with the question: "Do you 
know Xanthias the son of Glaucus ? " 

Morosophus: Yes, but he seemed to me a very ordinary man 
and quite unfit to aid in such inquiries. 

Protagoras: To me he seemed quite wonderful and a great 
proof of the truth I have maintained. For the wretch was ac- 
tually unable to distinguish red from green, the color of the 
grass from that of blood ! You may imagine how he dressed, and 
how his taste was derided. But it was his eye, and not his taste, 
that was at fault. I questioned him closely and am sure he 
could not help it. He simply saw colors differently. How and 
why I was not able to make out. But it was from his case and 
others like it, but less startling, that I learned that truth and 
reality are to each man what appears to him. For the differences, 
I am sure, exist, even though they are not noticed unless they 
are very great and inconvenient. 

Morosophus: But surely Xanthias was diseased, and his 
judgments about colors are of no more importance than those of 
a madman. 

Protagoras: You do not get rid of the difficulty by calling it 
madness and disease. And how would you define the essential 
nature of madness and disease? 

Morosophus: I am sure I do not know. You should ask 
Asklepios. 

To which Protagoras remarks : " Ah ! he is one of those 
gods I have never been able to meet." 

One does not get rid of difficulties by calling them abnormal. 
Giving them this appellation does not explain them. Hence 
the CEdipus hypothesis may be utilized to analyze everybody's 
activities, not those of the neurotic alone. To say that only the 
neurotic has to deal with an CEdipus fantasy is absurd; every- 
body does : but how ? The way the individual handles his CEdi- 
pus fantasy ; how far it has evolved away from its infantile stages, 



THE CEDIPUS HYPOTHESIS 5 1 

this is what determines whether he shall be termed neurotic or 
not, normal or abnormal. 

What then is the CEdipus hypothesis? For the sake of his- 
torical completeness it may be recalled that it received its name 
from the drama of CEdipus Rex, a mythological theme in great 
favor among the Greeks of the Epic period. The psychoanalyst 
should read the various renderings of it. It is fully treated 
psychoanalytically in " The Myth of the Birth of the Hero "^ by 
Rank, also in the same author's " Inzest Motive," both of which 
works have been mentioned. 

To the philistine the story simply means that CEdipus killed 
his father and married his mother ; but it implies infinitely more 
than this. It is the psychical elaboration of an enormously im- 
portant part of a biological instinct. It is the conversion of energy 
into symbolic activities that at lower social stages was expended 
at physical levels. 

How this evolution towards the conversion of energy into sym- 
bolic form took place cannot be entered into fully here. 

Freud has shown in his " Three Contributions to the Theory 
of Sex "^ that on rigid analysis the instinct of reproduction re- 
duces itself to the choice of a proper object — the object choice; 
and of the proper aim, i. e., the reproductive act. To sat- 
isfy the first requirement an individual of the opposite sex must 
be the libido object. This sounds so trite as to hardly require 
stating, yet the merest superficial acquaintance with human as 
well as infrahuman activities reveals how much variation of at- 
traction exists in a direction away from the consciously obvious 
heterosexual object. 

The second requirement is successfully met with when the 
partial libido trends already discussed on page 40, become 
united to successfully establish the primacy of the genital zone. 
The variations from this equally obvious goal are also so fre- 
quent that the observant inquirer is struck with amazement at 
the various faulty adjustments of what is so frequently consid- 
ered a " natural " function. 

We are now speaking solely of mechanisms which have been 
laid down for many million years and which are instinctively 
and unconsciously forming, but, it must be recalled, they are 
extremely variable in their external modifications when it comes 

1 Monograph Series, No. 18. 

2 Second English edition from third German edition, 1916. 



52 THE TECHNIQUE OF PSYCHOANALYSIS 

to their permitted socially-controlled and consciously-guided ac- 
tivities. 

It is to this broad reproductive instinct, in all of its conscious 
and unconscious manifestations, that Freud has applied the 
term sexual. In this present volume on the Technique of Psy- 
choanalysis, sexual means any human contact actual or sym- 
bolic by means of any sensory area with the object of the same 
or of the opposite sex, which has productive creation for its pur- 
pose, be it concretely in the form of a child, or symbolically as an 
invention, artistic production, or other type of mutually creative 
product. It does not apply to those contacts which have purely 
nutritive or self-preservation instinct behind it. And it does not 
apply solely to genital contacts. 

Thus it might be stated, though such a statement might seem 
to be paradoxical, that prostitution is not really sexual. It has 
come to be stigmatized because it utilizes the love principle for 
purposes of gain, and stands as a symbol of the destruction of 
society rather than that of its upbuilding. If in biblical phrases, 
"the love of money is the root of all evil" then prostitution 
symbolizes that root, and as later will be pointed out it repre- 
sents in its pure type chiefly an infantile anal erotic complex. 
It is a satisfaction of unconscious hate rather than of love in 
terms of the CEdipus hypothesis. 

The CEdipus hypothesis then attempts to establish some crite- 
rion, or group of criteria, by which human conduct may be 
valued as it looks forward to ultimate social or pragmatic truth, 
or goodness. It first directs attention to the biological trend 
of getting away from the type represented by the parent of the 
same sex, to a getting toward the type represented by the parent 
of the opposite sex. Without this biological direction of libido, 
no concrete social structure is possible. It is not father hate 
and mother love for the boy, and vice versa for the girl, in 
terms of conscious psychology, as is so often said by the critics. 
The CEdipus hypothesis has nothing whatever to do with con- 
scious psychology, any more than the chemical formulae of the 
fats in butter have to do with milking a cow. A knowledge 
of these formulae for fats may prove the ultimate basis for the 
valuation of a herd of cows, just as the application of the CEdipus 
formulae will permit of the comprehension of the acts of a family 
and thus determine their social value. 



THE CEDIPUS HYPOTHESIS 53 

So-called shrewd practical observers may make excellent 
estimates of cows as well as of citizens, but when it comes to 
correcting the mistakes, in order to get shrewder and more prac- 
tical observations, some measuring instruments are needed. 
Hence psychoanalysis utilizes the QEdipus instrument of pre- 
cision. 

In obtaining the full family history the analyst is getting 
the material from which a proper estimate of the evolution of 
the patient's psyche may be gathered. This it must be remem- 
bered is the conscious estimate of the patient's relations to the 
members of his family. 

These conscious attitudes to the members of the family group 
are not, however, invariable criteria of his more fundamental 
unconscious ones, yet they are of great importance in affording 
clues to early infantile repressions. The family is the first 
training camp, as it were, for the child's activities in gaining his 
social bearings. His later attitude toward men, women and 
things is patterned largely after his infantile models. We can 
here trace the workings of the CEdipus formula in its gradual 
evolution away from phantasy to reality. 

This formula has shown that the boy must have certain atti- 
tudes toward others of the same sex, mostly antagonisms, from 
the primitive wellspring of energy, and attractions toward all 
others of an opposite sex. 

A young woman to whom, in the early days of my psycho- 
analytic work, I had announced the QEdipus principle rather 
crudely, responded with much heat, " But I have always loved 
my mother, and we three sisters are devotedly attached to one 
another. The idea of rivalry among us sisters is impossible." 

" Yes, yes," I said, " that is true, but you are speaking of 
your conscious attitudes. We will not comprehend the pain 
between your shoulder blades by accepting the conscious attitude 
as the whole story, we must see what is on the other side of the 
picture." 

It did not take long, by the study of the unconscious processes, 
to find that the pain between the shoulder blades was the symbol 
of a " stab in the back " from her, consciously, most loved sister. 
Behind it lay concealed a very intense rivalry, a rivalry which, 
as will be seen, is a necessary part of the working out of the 
CEdipus idea, and one which, it may be maintained, is a neces- 
sary aspect of a comprehensive biological scheme for social 
5 



54 THE TECHNIQUE OF PSYCHOANALYSIS 

evolution. The sister was really trying to steal her sweetheart. 
She was " stabbing her in the back." 

This biological scheme has been stressed particularly by Rank 
in his study on the " Myth of the Birth of the Hero " and he has 
called it the " family neurotic romance."^ It is a universal 
phenomenon, and must be worked out with each patient. They 
must see for themselves how they have evolved their own dream 
of power in opposition to all the other members of the family. 

I am assuming that Rank's fundamental study will be read by 
one interested in mastering the technique of psychoanalysis, yet 
it belongs in this place in the development of the CEdipus hy- 
pothesis and a short resume of the chief principles involved is 
desirable. 

Every child is an egoist. It has been seen why this must be 
so in order that he may live at all. It is equally obvious that if 
social adaptation is to take place, he cannot remain one, at least 
not at an infantile level. Every child, in his egocentric fashion, 
constructs for himself therefore his little hero-myth. The will 
for power, in danger, thrusts in a phantasy substitute and thus 
aids the work of repression, as we have already discussed. Inas- 
much as the stages through which any one individual child may 
go are usually much abbreviated, and difficult of interpretation 
by himself, of himself most of all — that is why most of us deny 
we have ever had such fancies — Rank turned to a study of the 
hero myths of the world, and by a comparative study of these 
ancient sagas, was able to reconstruct what goes on in every 
child probably, although, for many, such processes are hidden. 
The evolutionary principle of recapitulation again does service 
in the understanding of these psychical structures. 

The standard principle for these ancient hero-myths is for- 
mulated as follows : " The hero is the child of most distinguished 
parents ; usually the son of a king (with us some important per- 
sonage, governor, millionaire, or what not). His origin is pre- 
ceded by difficulties, such as continence, or prolonged barrenness, 
or secret union of the parents, due to external prohibitions or 
obstacles. During the pregnancy, or antedating the same, there 
is a prophecy, in form of a dream, or an oracle, cautioning against 
his birth, and usually threatening danger to the father or to his 
representative. As a rule he is surrendered to the water, in a 
box. He is then saved by animals, or by lowly people (shep- 

3 Monograph Series, No. i8. 



X 



THE OEDIPUS HYPOTHESIS 55 

herds), and is suckled by a female animal, or by a humble woman. 
After he has grown up he finds his distinguished parents, in a 
highly versatile manner, takes his revenge upon his father, on 
the one hand, is acknowledged on the other, and finally achieves 
rank and honors." 

This is the child phantasy of the race, in highly condensed 
form. Even in the mythological stories themselves, this ground 
pattern, as it were, is departed from, and it is therefore conceiv- 
able that one rarely finds it in pure form at the present time, save 
in some psychotics, particularly in the group which, as defined 
by Bleuler and Jung, is termed schizophrenia, or dementia praecox. 
Here the ancient formula is repeated true to type. In minor 
degrees and in the greatest variety of disguises the psycho- 
neurotic follows out parts of the program. As Freud has pointed 
out these individuals remain children or infantile in certain as- 
pects of their strivings ; they are close to the unconscious. As 
Rank has put it, " The fancies of neurotics are, as it were, the 
uniformly exaggerated reproductions of the childish imaginings." 
But as we have so often remarked, these are closed to the ordi- 
nary modes of investigation and the psychoanalytic method has 
become the best method of reaching them at the present time. 

Rank has sketched the chief outlines of the biological need 
for getting away from the parents. " Except ye leave father and 
mother, ye shall not enter the kingdom of heaven," I conceive to 
be a much earlier statement of the same situation. In the realm 
of plant life Darwin's penetrating studies that showed the values 
of cross-fertilization is collateral evidence in a realm of biolog- 
ical activities far below man, and the whole biological scheme of 
things reveals the ceaseless experiments that nature goes through 
with in the hope that advanced types may result. Just what 
particular evolutionary formula will appeal to the analyst or 
analyzed, should one be^ invoked at all, whether it smacks of Neo- 
darwinism, Neolamarckianism, or follows out the Mendelian 
principle, or De Vries's Mutation hypothesis, not to mention 
others, is absolutely immaterial in the development of the gen- 
eral idea. If the patient should be an out and out opponent to 
any evolutionary hypothesis at all, then the whole psychoanalytic 
scheme will have little value to him. In general, I assume that 
the analyst has a working knowledge of the general biological 
hypotheses concerning evolution and heredity. 

In the human family, psychoanalysis emphasizes, as Rank 



56 THE TECHNIQUE OF PSYCHOANALYSIS 

has phrased it, "the detachment of the growing individual from 
the authority of the parents is one of the most necessary, but 
also one of the most painful achievements of evolution. It is 
absolutely necessary for this detachment to take place." Anal- 
ysis shows how the psychoneurotic is endeavoring to accomplish 
the task and also indicates how the healthier individual has really 
accomplished it in various ways. The manner of cure, or the 
rationale of psychoanalysis, how it acts, may be very definitely 
demonstrated in the tracing of the individuaFs growing inde- 
pendence from his parental complexes. 

To still further illustrate this absolutely essential separation 
I not infrequently use a simple illustration. Putting the problem 
of the apple tree, I ask, "What would happen if all the seeds 
should attempt to grow under the parent tree?" It is an easy 
step from this illustration to a discussion of the thousands of 
devices which plants and animals have elaborated to make sure 
of the dispersal of their seeds or offspring. The ingenious cling- 
ing seeds that fasten to one's clothes or to the fur of animals, the 
various winged seeds that fly like the thistledown, or dandelion, 
those that float, or those that pass through the intestines of ani- 
mals, the devices are legion and the ingenuity marvellous.* 
Parent and child must be separated. 

" Social progress — speaking now of higher forms — is essen- 
tially based upon this opposition of the two generations," writes 
Rank, who then points out how the failure to get away from the 
parent is paramount to a neurosis. 

"For the young child, the parents are in the first place the 
sole authority, and the source of all faith. To resemble them, 
i. e,, the progenitor of the same sex; to grow up like father or 
mother, this is the most intense and portentous wish of the child's 
early years. Progressive intellectual development naturally 
brings it about that the child gradually becomes acquainted with 
the category to which the parents belong. Other parents become 
known to the child, who compares these with his own, and thereby 
becomes justified in doubting the incomparability and uniqueness 
with which he had invested them. Trifling occurrences in the 
life of the child, which induce a mood of dissatisfaction, lead up 
to a criticism of the parents, and the gathering conviction that 
other parents are preferable in certain ways, is utilized for this 

* Consult Koerner von Marilaun, Natural History of Plants ; Fabre, 
Souvenirs Entomologiques. 



THE CEDIPUS HYPOTHESIS 57 

attitude of the child toward the parents. From the psychology 
of the neuroses, we have learned that very intense emotions of 
sexual rivalry are also involved in this connection. The causa- 
tive factor evidently is the feeling of being neglected. Oppor- 
tunities arise only too frequently when the child is neglected, or 
at least feels himself negected, when he misses the entire love of 
the parents, or at least regrets having to share the same with the 
other children of the family. The feeling that one's own inclina- 
tions are not entirely reciprocated seeks its relief in the idea — ' 
often consciously remembered from very early years — of being 
a stepchild, or an adopted child. Many persons who have not 
become neurotics, very frequently remember occasions of this 
kind, when the hostile behavior of parents was interpreted and 
reciprocated by them in this fashion, usually under the influence 
of story books. The influence of sex is already evident, in so 
far as the boy shows a far greater tendency to harbor hostile 
feelings against his father than his mother, with a much stronger 
inclination to emancipate himself from the father than from the 
mother. The imaginative faculty of girls is possibly much less 
active in this respect. These consciously remembered psychic 
emotions of the years of childhood supply the factor which per- 
mits the interpretation of the myth. What is not often con- 
sciously remembered, but can almost invariably be demonstrated 
through psychoanalysis, is the next stage in the development of 
this incipient alienation from the parents, which may be desig- 
nated by the term Family Romance of Neurotics. The essence 
of neurosis, and of all higher mental qualifications, comprises 
a special activity of the imagination which is primarily mani- 
fested in the play of the child, and which from about the period 
preceding puberty takes hold of the theme of the family rela- 
tions. A characteristic example of this special imaginative fac- 
ulty is represented by the familiar day dreams, which are con- 
tinued until long after puberty. Accurate observation of these 
day dreams shows that they serve for fulfilment of wishes, for 
the righting of life, and that they have two essential objects, 
one erotic, the other of an ambitious nature (usually with the 
erotic factor concealed therein). About the time in question the 
child's imagination is engaged upon the task of getting rid of the 
parents, who are now despised and are as a rule to be supplanted 
by others of a higher social rank. The child utilizes an accidental 
coincidence of actual happenings (meetings with the lord of the 



58 THE TECHNIQUE OF PSYCHOANALYSIS 

manor, or the proprietor of the estate, in the country; with the 
reigning prince, in the city ; in the United States with some great 
statesman, milHonaire). Accidental occurrences of this kind 
arouse the child's envy, and this finds its expression in fancy 
fabrics^ which replace the two parents by others of a higher rank. 
The technical elaboration of these two imaginings, which, of 
course, by this time have become conscious, depends upon the 
child's adroitness, and also upon the material at his disposal. It 
likewise enters into consideration, if these fancies are elaborated 
with more or less claim to plausibility. This stage is reached at 
a time when the child is still lacking all knowledge of the sexual 
conditions of descent. With the added knowledge of the mani- 
fold sexual relations of father and mother ; with the child's reali- 
zation of the fact that the father is always uncertain, whereas 
the mother is very certain — the family romance undergoes a 
peculiar restriction; it is satisfied with ennobling the father, while 
the descent from the mother is no longer questioned, but ac- 
cepted as an unalterable fact. The second (or sexual) stage of 
the family romance is moreover supported by another motive, 
which did not exist in the first or asexual stage. Knowledge of 
sexual matters gives rise to the tendency of picturing erotic situa- 
tions and relations, impelled by the pleasurable emotion of plac- 
ing the mother, or the subject of the greatest sexual curiosity, in 
the situation of secret unfaithfulness and clandestine love affairs. 
In this way the primary or asexual fantasies are raised to the 
standard of the improved later understanding. 

" The motive of revenge and retaliation, which was origi- 
nally in the front, is again evident. These neurotic children are 
mostly those who were punished by the parents, to break them 
of bad sexual habits, and they take their revenge upon their 
parents by their imaginings. The younger children of a family 
are particularly inclined to deprive their predecessors of their 
advantage by fables of this kind (exactly as in the intrigues of 
history). Frequently they do not hesitate in crediting the 
mother with as many love affairs as thete are rivals. An inter- 
esting variation of this family romance restores the legitimacy of 
the plotting hero himself, while the other children are disposed 

s Compare Freud, Hysterical Fancies, and Xheir Relation to Bisex- 
uality, with references to the literature on this subject. This contribution 
is contained in the second series of the Collection of Short Articles on 
the Neurosis Doctrine, Vienna and Leipsig, 1909. 



THE CEDIPUS HYPOTHESIS 59 

of in this way as illegitimate. The family romance may be 
governed besides by a special interest, all sorts of inclinations 
being met by its adaptability and variegated character. The 
little romancer gets rid in this fashion, for example, of the kin- 
ship of a sister, who may have attracted him sexually. 

" Those who turn aside with horror from this corruption of 
the child mind, or perhaps actually contest the possibility of such 
matters, should note that all these apparently hostile imaginings 
have not such a very bad significance after all, and that the 
original affection of the child for his parents is still preserved 
under their thin disguise. The faithlessness and ingratitude on 
the part of the child are only apparent, for on investigating in 
detail the most common of these romantic fancies, namely the 
substitution of both parents, or of the father alone, by more 
exalted personages — the discovery will be made that these new 
and highborn parents are invested throughout with the qualities 
which are derived from real memories of the true lowly parents, 
so that the child does not actually remove his father but exalts 
him. The entire endeavor to replace the real father by a more 
distinguished one is merely the expression of the child's longing 
for the vanished happy time, when his father still appeared to he 
the strongest and greatest man, and the mother seemed the dear- 
est and most beautiful woman. 

" The child turns away from the father, as he now knows him, 
to the father in whom he believed in his earlier years, his imagi- 
nation being in truth only the expression of regret for this happy 
time having passed away. Thus the over-valuation of the earli- 
est years of childhood again claims its own in these fancies.* 
An interesting contribution to this subject is furnished by the 
study of the dreams. Dream interpretation teaches that even in 
later years, in the dreams of the emperor or the empress, these 
princely persons stand for the father and mother. Thus the 
infantile over-valuation of the parents is still preserved in the 
dream of the normal adult. 

" As we proceed to fit the preceding features into our scheme, 
we feel justified in analogizing the ego of the child with the hero 
of the myth, in view of the unanimous tendency of family 
romances and hero myths ; keeping in mind that the myth through- 
out reveals an endeavor to get rid of the parents, and that the 
same wish arises in the phantasies of the individual child at the 
time when it is trying to establish its personal independence. 



60 THE TECHNIQUE OF PSYCHOANALYSIS 

The ego in the child behaves in this respect like the hero of the 
myth, and as a matter of fact, the hero should always be inter- 
preted merely as a collective ego, which is equipped with all the 
excellences. In a similar manner, the hero in personal poetic 
fiction usually represents the poet himself, or at least one side of 
his character." 

The beginner who, for the first time, approaches these mecha- 
nisms of getting away from the parents, has really only the 
faintest conception how the scheme works in everyday life. I 
must reiterate to him that he constantly keep in mind all of the 
partial libido trends. Each must be followed out in its most 
minute series of transformations, and the patient gradually sees 
for himself, in some special form of conduct, such as love for 
certain forms of play, nutrition customs, likes and dislikes of all 
kinds, just how successful or not his getting away from his infan- 
tile attachments has been. Every infantile attachment means 
locked-up energy, which cannot be used for useful work. They 
are the "messengers from the unconscious," which Bergson 
speaks of, "which escaping through the half open door, remind 
us of what we are dragging behind us unawares." 

I wish to illustrate these points by a partial statement of an 
actual history and by means of a diagram : 

This patient was a young man of 28 years of age, of good 
family. His father was a successful business man. He had two 
brothers, older than himself, and two sisters living; one sister 
had died. He began to drink at sixteen, smoked since he was 
ten. His father was a drinking man, at times excessively so, 
also one brother. He went through school and entered college 
but did not persist, as his gradually increased drinking bouts in- 
terrupted the discipline, of which there was little at home. He 
went into business but did not apply himself particularly. He 
was a charming, good-looking, " gentleman^s " son with plenty of 
money. 

His drinking bouts were becoming more or less continuous. 
He would be feeling perfectly well, would take a drink, usually 
of whiskey, then another, and from that time nothing short of a 
strait- jacket could hold him ; he was suave and courteous and 
convincing if he had his own way, but he would be a very rough 

6 For the idealizing of the parents by the children, compare Maeder's 
comment's (Jahr. f. Psychoanalyse, p. 152, and Centralblatf f. Psycho- 
analyse, I, p. 51), on Varendonk's essay, Les ideals d'enfant, Tome VII, 
1908. 



THE CEDIPUS HYPOTHESIS 6 1 

customer if opposed. After twelve, twenty-four, thirty-six or 
sometimes seventy-two hours or more of this he would be a wreck 
and would have to be taken care of. Sometimes the bout would 
last two or three weeks. They were becoming frequent, and his 
last bout, before I saw him, was attended with meningeal symp- 
toms and signs of general toxemia, mild jaundice, etc. 

The picture is familiar to many. I do not intend to detail 
the analysis, I shall only utilize some of the facts revealed to 
show, in part, what the whole thing meant, in terms of the work- 
ing out of the CEdipus hypothesis, the family neurotic romance, 
and the later phase of this same situation, namely narcissism. 

Analysis uncovered a great deal of material, but I wish only 
to direct attention to this patient's eating habits by way of illus- 
trating the meaning of what this chapter seeks to emphasize, 
namely the failure to develop away from the infantile manner of 
handling the CEdipus phantasy. 

Asking him one day what he ate for breakfast he said, 
" Sausages, waffles and maple syrup," and for supper ? ''I don't 
remember." 

And yesterday for breakfast ? " Sausages, waffles and maple 
syrup." He could not remember what else he had eaten. Every 
morning he ate the same breakfast, and had done so for fifteen 
years or more. He ate no vegetables, except potatoes; he ate 
a variety of meats. 

Now what has this to do with the CEdipus hypothesis ? 

Before we go further with the discussion let me put in a 
diagrammatic form what is the general scheme I am after. I 
shall again utilize the diagram (modified in circular form) that 
has already been used to show the first steps in libido distribu- 
tion following birth.'^ It is not meant to show every detail in 
the evolution of the partial libido trends — it is, as was the pre- 
ceding diagram, only suggestive. 

All of our present-day activities, which manifest themselves 
in the various life contacts, may for our purpose be represented 
by a circle. At the periphery we may arrange the conscious acts 
of daily life. In this diagram the libido area distributions are 
arbitrarily represented by six sectors, showing the first distribu- 
tions, i. e.j, the partial libido trends, already discussed (see p. 40). 
I have only partially elaborated one sector, i. e., the nutritive 
sector, since I am engaged in placing the dietary habits of the 

7 Page 40. 



62 



THE TECHNIQUE OF PSYCHOANALYSIS 



patient under discussion somewhere in the scheme. If the dis- 
cussion should have turned on why a patient ended his sentences 
in a little giggle, or another toyed with a button on his coat most 
of the time, the particular evolution might have been shown in 



^^mJTSLlTVm LIBIDO ETOIUTIQN ^, 




Diagrammatic suggestion of the , evolution of the libido trends. The 
path taken by the patient's nutritive interests, and hence his sympathetic 
contacts (social evolution particularly of his sociability) have become nar- 
rowed to a persistent restricted and narrow diet, the meaning for which, 
in his individual case, meant failure to get away from the parents, i. e., in 
the unconscious sense of the (Edipus formula. The diagram suggests the 
line taken by this in the slightly shaded circles. 

the respiratory, or the skin sectors, which for the purposes of 
this illustration are here left blank. I am engaged in placing this 
particular patient's partial libido trends, as far as one particular 
series of acts are concerned, in relation to the CEdipus concept. 

This boy's first nutritive libido concerned itself with his 
mother's breast. Milk was his sole food. This is diagram- 



THE CEDIPUS HYPOTHESIS 63 

matically shown on the first circle, in which the initial partial 
libido trends are represented. From here on, it may be inferred, 
the evolution of man's nutritive interests becomes more and more 
complex, until at the stage of evolved manhood, the nutritive 
libido occupies a large part of man's interests. In the U. S. 
Census for 1900, it is estimated that one third of the adult popu- 
lation of the U. S., some twenty million at least, make their liv- 
ing in pursuits which contribute directly to the nutritive libido. 
Here we see man's interests, into which active energy goes, con- 
cerning itself with pots and pans, agricultural instruments, crops, 
etc. I need not complete the picture. It is so obvious. Yet 
when we come to discuss the patient's nutritive libido we find a 
very striking fact, that of its monotony. It has not evolved. 
He has eaten the same breakfast for the past sixteen years, eats 
no vegetables save potatoes and several meats. He has no in- 
terest in foods outside of this limited dietary. If I should at- 
tempt to place his nutritive libido stage of evolution I would 
place it at an infantile level, say arbitrarily on the second circle, 
which is here represented. From this point on to the present 
it has not undergone any modification, as has been schematically 
shown. I might say all sociability, so far as these nutritive in- 
terests are concerned, is thus restricted. 

Now, turning to the mother-father relationships, the first 
fact that strikes one is its failure to branch out. It remains 
closer to a monotonous infantile food — milk — and fails to show 
a wider, richer dietary. I am not generalizing about the sig- 
nificance of a Hmited dietary for all people. Every tub stands 
on its own bottom. Here I am simply taking a particular case 
and seeing what it means for this particular individual. It repre- 
sents, in terms of the CEdipus concept, an infantile attachment 
to the mother. It is a way by which he unconsciously and sym- 
bolically hangs on to the mother. Let me now add that milk is 
also taken instead of coffee, tea or cocoa. Free associations, 
with milk, concerning which we shall speak, brings the patient 
directly to his mother. Interesting also free associations on 
sausages show that he prefers small ones, thin ones, and mother's 
" nipple " turns up in his associations, as well as the word " penis." 

Associations to " waffles," also, brings us to " nipples," " teats," 
to the "irons in which they are cooked" — "colored woman's 
breasts," "pigs' tits," were some of the free associations. 

I shall not give further details to show unconscious associa- 



64 THE TECHNIQUE OF PSYCHOANALYSIS 

tions establishing the relationships between the infantile mother 
phantasy and the dietary customs making up this monotonous 
breakfast. 

We have seen, however, that the (Edipus hypothesis involves 
two contrasting situations, one of unconscious attachment to the 
parent image of the opposite sex, the other connoted by the un- 
conscious antagonism to the father-brother image. There is 
plenty of evidence to show the unconscious dpsire to get rid of 
his father and brother in his drinking bouts. It is further ex- 
tremely valuable to note that this diet also represents a " castra- 
tion motive," meaning symbolically the overcoming of the father. 
Furthermore, the only other feature of his diet, namely his free 
choice of meats, has an intricate motivation. For him, as for 
many children, meats and vegetables fall into the strong and weak 
group respectively. Animism so regards them, and the young 
human passes through this psychological animistic phase. Many 
people, as we know, never get away from their, crude animistic 
notions regarding foods, and a study of these makes many 
dietary faddisms comprehensible and fascinating. Meats are to 
make him strong and powerful. They therefore will help him 
in overcoming his father, or his representative, his older brother. 

I have very rapidly sketched some of the salient points in 
the elucidation of the food habits of this patient and wish to 
stress more particularly their failure to evolve and therefore the 
gap in this individual's interests which is the center of endeavor 
for 25 per cent, of all of the people he meets. I might say for 
purposes of illustration, that he thus cuts himself out of sym- 
pathetic contact and interest from one quarter of his entire social 
environment by this simple failure of development — by this un- 
conscious utilization of the OEdipus fantasy as seen in his dietary 
customs. He limits thereby a very important factor in the free- 
ing himself from the limited family group to enter the larger 
social groups, namely the factor of sociability as it is termed. 

I need not go on to say that a similar failure to develop along 
a number of other libido channels has contracted his sympathetic 
social contacts, i. e., his sociability, down to a minimum. This is 
a part of the motivation for his drinking. It aids him to get 
away from the consciousness of his inferiority. But I only 
started out to give a concrete example of how the CEdipus 
hypothesis is applicable to a specific bit of conduct. 



THE CEDIPUS HYPOTHESIS 65 

I shall only add that every bit of conduct, every taste, or 
inclination, like or dislike, is capable of a similar analysis, and 
the analytic technique aids the patient to see how his everyday 
acts have come to have the value and significance that they have. 

When the subject of the utilization of the dream is taken 
up we shall see that the evidence is overwhelming with reference 
to the constant activity of the CEdipus phantasy. 

We then return to the point from which we started, that the 
CEdipus hypothesis is utilized as a sort of measuring rod to de- 
termine the grade of evolution of psychological activities, looking 
forward to ultimate social values. The analysis of one's acts 
shows, schematically speaking, how far on the circles of evolu- 
tion the particular act may be placed, whether it remains an in- 
fantile fantasy way of obtaining satisfaction from the mother- 
father attachment or rejection (according to sex) or a grown up 
sublimation way which is socially, and hence also individually 
valuable. Identically the same energy is utilized, but "by their 
fruits shall ye know them." 



CHAPTER V 

Transference and its Dynamics, the Basis of Social 
Integration and the Lever in Psychoanalysis 

The dynamics of the entire psychoanalytic situation and the 
possibilities of cure by its application lie in the correct management 
of the transference. Inasmuch as these notes have been planned 
for the beginner in psychoanalysis it is desirable to have a fairly 
clear idea of what is meant by transference. 

There is no adequate definition of transference. In fact the 
whole attitude of this series of articles is one distinctly opposed to 
the utilization of definitions. Definitions are too apt to be sterile 
condensations of the meaning of words rather than dynamic prin- 
ciples for the understanding of things. Hence I shall not try to 
define transference, I shall attempt to describe it. 

In order to do this I must again remind the beginning analyst 
what we have considered to be the chief goal in the libido striving. 
Libido is considered in this series of articles as the living vital 
energy, which, flowing into various forms, as Bergson has so well 
expressed it, may be compared to a string of pearls. The organized 
living forms of plants and animals are comparable to condensations 
at different points along the string. We term the latest crystalliza- 
tion man, the next, possibly, shall we say, the superman, not that of 
Nietsche, but the true superman, the futuristic, socialistic ideal, 
more closely allied to the symbolic Christian ideal than any as yet 
reached. In its endeavor to make the superman, this libido utilizes 
the principle of reproduction. It may thus possibly reach its goal, 
physical immortality. We are considering human problems for 
human beings and are not interested in questions 'that have no 
human interests. Hence whether there i^ a life after death, or not 
we shall not discuss. Why man wishes one however we shall take 
up. The presence or absence of the fact is of little significance. 
For humans it has no solution; but the wish is essentially human 
and occupies the very focus of the problem we have set out to com- 
prehend in this chapter. 

, Our formulations have taken us thus far to posit the instincts of 
reproduction and self-preservation as the essential and fundamental 
symbols underlying the process of living. From this point of view 

66 



TRANSFERENCE AND ITS DYNAMICS 67 

all other so-called instincts are only combinations, amplifications or 
partial elaborations of these. In their last analysis they are re- 
ducible to these. In many recent works on character traits, etc., a 
number of instincts have been described. Thus in Macdougall's in- 
teresting Introduction to Social Psychology and in Shand's Foun- 
dations of Character, one finds that there are the instincts of fear, 
repulsion, pugnacity, curiosity, self-abasement, self-assertion tender- 
ness, reproduction, gregariousness, acquisitiveness, constructiveness, 
hunger, sympathy, suggestion, play and imitation. While it may be 
thoroughly practical to use these instinct definitions in those settings 
for which they are adapted, yet for the psychoanalyst they are com- 
pounds, capable of reduction to the fundamentals which have been 
recognized for centuries. Of all recent writers Adler in his Nerv- 
ous Character has resolved them nearer their original well-spring 
than any others. 

If then concrete immortality is the goal of the libido striving, 
which is reached either directly and foremostly through the birth 
of children and secondarily through building up of social structures 
and all that goes to make life worth living, then it is extremely 
simple to comprehend that the symbol of power to bring this about 
should be expressed, for the adult, in terms of the primacy of the 
genital zones. Potency becomes the guiding ideal. The direct 
opposite of personal immortality is death. Desire as a constructive 
forward push of the libido is therefore symbolized as potency. 
Fear becomes the opposing symbol of impotency and is likened to 
death. 

In this sense then one says that through the study of desire and 
fear one can arrive at a complete comprehension of the motives of 
life. This we do not believe to be true, because as we have already 
seen, desire and fear are evolutions out of simpler components. It 
has been shown particularly by Jung that before the period of the 
development of the ego consciousness of the child — arbitrarily here 
considered as occurring about the age of 5 — there is no desire goal 
as a whole. This is the period of the partial libido trends, discussed 
on page 40. 

If this is true for desire, it is probably true for fear. This 
attitude is completely set forth by Stanley Hall,^ who says, " Fear 
is the anticipation of pain. For those forms of life capable of fear 
this anticipation is not prevision but only a highly generalized fore- 

^ Synthetic Genetic Study of Fear, Am. Jour. Psychology, April, 1914, 
XXV, pp. 149-200. 



68 THE TECHNIQUE OF PSYCHOANALYSIS 

feeling, itself unpleasant, that a yet more painful state impends. 
The will to live, the elan vital, is more or less checked in its mo- 
mentum or narrowed in its range by some kind of intimation that 
it may be still further held up. This protensive or futuristic attitude 
or orientation toward a pejoristic state is the specific quale of the 
psychic condition called fear. Psychoanalytically it is a primitive 
Anlage of futurity and it is the most stimulating and vivid of all 
its forms of presentation. In fear the future dominates the present 
and gives it a new significance in addition to its own, and but for 
fear pain could do but little of its prodigious educative work in the 
animal world. Fear is thus the chief paradigm of psychic prolepsis 
as well as the chief spur of psychic evolution. The Einstellung it 
motivates to the 'what next' and the * about to be' may become, 
second only to present pain, the most intense of all psychic experi- 
ences. This power to fore-feel pain, although not unanalyzable 
genetically, is nevertheless primary, unitary and unique enough to 
be considered practically, if not scientifically, as indeed it always has 
been popularly, as a primary category of the emotional or affective 
life. In its most generic form it is identical in all stages of animal 
life, for the function of pain-anticipation is common to and under- 
lies all its innumerable differentiations as to objects, its degrees, 
physiological concomitants and modes of expression. 

" Fear has only one genetic presupposition and that is some ex- 
perience, individual or racial, up and down the algedonic scale. 
There must have been suffering and this must have left some trace. 
Here, then, we have germs of both memory and recollection, how- 
ever rudimentary and unconscious. From this point of view we 
may further define fear as revived traces or engrams of past pains 
in prospect of passing over into re-realization which latter is 
normally more intense than its merely reproduced forms. If pain 
had not been felt it could not be anticipated, hence the condition 
precedent of fear is some kind of registration (whether transmissible 
by heredity from forbears or individually acquired we shall discuss 
later) and some degree of revival of these vestings. Thus fear 
involves the past as we have seen it does the future. Without con- 
servation of past experiences there could be no fear, nor could 
there be if the phosphorescence of the traces left by the past were 
more painful than their dreaded reinstatement itself, which latter 
case indeed occurs, but only in certain psychalgias in which the pain 
of the present moment is so excruciating that any presentiment of a 
greater one is impossible. In a general sense, then, and subject 



TRANSFERENCE AND ITS DYNAMICS 69 

to many specific limitations, we may say that both the intensity and 
variety of fear depend on the intensity and variety of the pains that 
have before been felt. Too much suffering tends to timidity, too 
little exposes to avoidable dangers without either warnings or de- 
fenses, and the optimum between these extremes, which varies 
greatly with individuals, will some day be an attainable and perhaps 
individually prescribed goal of orthogenesis as it already is of 
psychotherapy. Not only are herbivora and all creatures being 
preyed upon timid and carnivora relatively fearless, but many 
phobias are the direct result of shocks and we may say in general 
that the first fear in the world could only come after a preceding 
pain." 

" In fact fear is intensely dynamogenic and also inhibitive. The 
prospect of actual pain puts to life the question of its very survival 
or extinction, complete or partial. Something bad has begun which 
is prelusive of something worse, but this worse must if possible be 
avoided. So feeling must pass over into doing. The narrowing 
of the pleasure field, or its conversion into its opposite, makes the 
strongest of all appeals to the efferent tracts to energize to their 
uttermost. Much conduct, behavior, many habits and even motility 
itself throughout the animal world might be described as more or 
less organized pain-fugues which are correlates of the pleasure- 
tropisms. Here belong all, perhaps even physiological, protective 
and defensive phenomena and methods of escape from enemies or 
the perils of the environment which are essential for survival and 
are precious because wrought out at great cost and through count- 
less generations. In the life of the individual, and still more in 
that of the race, the way of orthogenesis is relatively straight and 
narrow and is the result of more failures than successes in the trial 
and error processes of evolution." 

Thus there arises that thanatophobia, that fear of death, which 
in the course of thousands of years of evolution has given rise to 
the physician — ^to medicine in the large. 

We may without thinking say that the physician's function is to 
cure the sick, prevent sickness, etc., etc. This is the naive con- 
ception of the conscious. The physician is much more than this 
in the unconscious life of the community. If it were not so there 
would be no problem of transference, and no need for any compre- 
hension for the whys and wherefores of the misery and suffering 
found in an as yet very imperfect world. 

The physician is a projected wish of the individual's own un- 

6 



70 THE TECHNIQUE OF PSYCHOANALYSIS 

conscious. The physician becomes the agent whereby individual 
immortality may possibly be accomplished. Medicine, in its broadest 
bearings, is the projected wish of the community to ensure its con- 
tinuance. 

I have stated this in a slightly different form as follows :^ " The 
physician, viewed as a functional unit in society, represents for the 
individuals in that society, that portion of themselves given over to 
the protection of their bodies from the forces of disease. Each 
patient therefore identifies the physician as a part of himself, a 
special part, and psychically speaking, identical, if like the rest of 
himself, i. e., if there is sympathetic insight. This sympathetic in- 
sight, this identification with self, or if you will, stating it in other 
terms, this taking up of the father-image, the mother-image, the 
brother-image, is one of the fundamental causes for the transference 
given to the physician. Without it, the physician lies without the 
pale, and so far as the psychical life is concerned, can be of little 
or of no service." 

The patient's relation to the physician in the treatment of psycho- 
genic disorders — and all human ailments have mental components — 
is therefore a much more fundamental and human affair than most 
physicians realize. The intensity of the unconscious feeling is 
known to but few, or felt by the many only at certain more vital 
moments in life, and that often but for a moment. The physician 
is from the unconscious point of view constantly involved as a 
symbol to afford that sense of security which in the unconscious is 
to exclude the fear of death — physical, financial or social. 

1 desire before going further to call attention to another study 
by Stanley Hall which is a most masterly presentation of this fear 
of death, without a comprehension of which there can be little 
understanding of the principles of psychoanalysis. He says rela- 
tive to the present theme,^ epitomizing very roughly, (i) that fear 
of corpses is quite primitive, although found in infants only in the 
form of a nervous shudder set off by coldness, immobility, pallor, 
sunken and partly closed eyes, etc., on a background of strange sur- 
roundings with the social contagion of grief. The death-fears of 
generations of human forbears are inherited in the form of neural 
predispositions to shudder, but with no intelligence and little or no 
consciousness. This is more reflex than instinctive but in it is the 

2 Some Notes on Transference, Journ. Abn. Psychology, 1914. 

3 Stanley Hall, Thanatophobia and Immortality, Am. Jour. Psychol,, Vol. 
26, No. 4, October, 1915, pp. 566-569. 



TRANSFERENCE AND ITS DYNAMICS 7I 

promise and potency of a mass of later and higher reactions. Here 
the analogy with sex is close for ludeln and liitschen and infantile 
anal and other isolated prelusions of sex are on the same level. 
They are fragmentary partial impulses (Triebe) with no awareness 
of sex but are only the first ontogenetic expressions of a long 
phyletic experience with sex. As the first naive infantile curiosity 
about sex is soon powerfully repressed, so the first interest in death 
suffers multifarious repressions. So effectively have shame and 
modesty stamped themselves upon our organism that we have many 
cases in which the first envisagements of sex cause a painful and 
normal repulsion, as in the case of the servant girl who laid an 
infant on the floor to make the bed, and by stepping over it aroused 
in the babe an aversion for all girls that lasted well on to puberty, 
or as in Ernest Poole's " The fiarbor " the boy of seven saw on a 
forbidden street a gross scene between a drunken sailor and a vile 
woman, which killed for a long time the great previous charm of 
that general locality, and again in the early teens when he saw the 
red garter that had accidentally slipped down over the ankle of his 
favorite girl playmate of twelve, he felt an aversion that sent him 
suddenly away from her for years, unconscious as it all was on 
the part of them both. Such cases illustrate how effectively nature 
arms the normal soul against sex precocity. In the same way she 
would shield the young child from the premature realization of 
death and allow it to linger in the animal plane before it was 
known. That necrophilism has its germs in infantile experience as 
truly as does anal eroticism there can be little doubt, although we 
have as yet few analyzed data on the subject. It of course goes 
with the fact that death is not known for what it really is.* 

(2) " The instinct to deck out, to beautify and perpetuate the 
corpse, occasionally to photograph and in Egypt to mummify it, is 
less analogous to the impulse to purify the exhibition of the nude 
body in art or to sacramentalize the sex act in phallic cults. Both 
tendencies developed in the teeth of a strong contravalent trend. 
Erotism toward corpses in the sense of Kraft't-Ebing and Tar- 
nowski might stand for the extremest form of the negation of death 
just as a truly immaculate conception, with suppression of all pas- 
sional lust in the interests of the offspring, wordd be the ambivalent 
pole, while mummification would be more like the ritualization of 
coitus : but in an article like this one can hardly dwell upon the 
details which to my mind validate this thesis. 

* See the literature already quoted for these psychoanalytic studies in 
nekrophilism. 



72 THE TECHNIQUE OF PSYCHOANALYSIS 

(3) "Diversion is plainer. From the fig leaf or breech cloth up 
to the wedding dress, flowers, gifts, nuptial ceremonies and customs, 
we have displacement from the acts and organs in which wedlock is 
consummated to hair, face, arms, movements, ritual, music, dot, 
honeymoon, etc., in ever-widening irradiation. So in death and 
funerals, attention is directed to grave clothes, the coffin and its 
trimmings, flowers, perhaps incense, chants, solemn religious cere- 
monials, feasts before and after, wakes, vigils, ending in a formal 
commitment of the body to the natural forces of disintegration. 
Of the bride and groom, as of the dead, we speak only good, and 
we would almost as soon speak ill of one lover to another as of the 
dead to surviving friends and mourners. As death of one mate 
often revives love where it had begun to languish so separation may 
fan the flame of affection and make for idealization. Death 
beautifies and perhaps beatifies, and also awakens the conscience of 
the survivor at the memory of real or fancied mistreatment. 

(4) " One of the chief causes that first suggested and then made 
man cling with such persistence to the belief in souls was the far 
greater difficulty in grasping death as annihilation. The passing 
of the body cannot mean the end of all. Something must servive, 
for the mind like nature abhors a vacuum, and hence we have to 
postulate something in place of the vanished body. The dead thus 
are not quite dead and from this faint suggestion slowly evolved 
the primitive ghost cults and finally fully panoplied heavens and 
hells, with the conception that the body was a mere husk or shell 
which, when it was sloughed off, liberated a far more glorious and 
enduring soul. Thus belief in the immortality of the soul arose 
partly as a compensation which man's artistic nature evolved to 
make up for the realization of the mortality of the body. It was 
a consolation-prize, precious because it atoned for the supremest of 
all calamities. So love, at first purely animal and selfish, slowly 
came to realize that it was not a finality but that it was for the 
sake of offspring. Love that is only physical and personal satis- 
faction means for fallen man the gradual extinction of his stirp, 
while eugenics, which is a new religion of life, regards chiefly the 
immortality of the germ plasm. It compensates for a love that is 
only scortatory, supplying another object than the mate, viz., the 
child, in which not only does passion find a vicariate but which 
gives an object on which those unmated can lavish all their affec- 
tion. Especially parents live on in their well-begotten and well- 
bred children, and when senescence has sapped the roots of mere 



TRANSFERENCE AND ITS DYNAMICS 73 

amorousness, love for offspring is distinctly reinforced, as we often 
see in the assiduity and indulgence of grandparents, which so exceed 
that of parents. Thus love provides for itself in the aged and in 
the unwed a normative surrogate for posterity. We have been 
told that the most prolific races and social classes in the Occident 
are those that believe in the immortality of the individual soul, and 
conversely that the least so are those that doubt it. If this be true, 
we have yet to find the mechanism of this correlation, but the fact, 
if it be such, is of the utmost psychogenetic as well as pragmatic 
importance. — 

(5) "Another great product of the fear of death and its agent, 
disease, is medicine and hygiene, to say nothing of all forms of 
life and health insurance, etc. Man's deepest impulse is to live as 
long, intensively and richly as possible, that is, to attain macro- 
biotism. Everything that checks this maximum is lethal, for both 
life and death are of all degrees, death being only the zero on the 
life scale. Fear is not merely the will to be immortal as StekeP 
defines it, but the will to live out completely all that is in us. We 
realize every possibility and expand every dimension of our nature. 
We long to be just as well, strong, happy and vital as possible, and 
strive against everything that impedes this wish or will, while we 
imprecate even our parents if through their fault we are born short 
or handicapped with disease. We love life supremely and cannot 
have too much of it, and foods, drugs and regimen are precious 
just so far as they minister to this end, while we dread all that inter- 
feres with it. This lust for extreme individuation, however, has at 
once its consummation and its reversal in love. It is at once the 
acme of self-affirmation and of self-renunciation, for it is no less 
kenotic or self-emptying, since subordination also begins in love, 
which must serve. Just as what we know as anger consists of only 
partial and almost erratic outcrops of the generic aggressiveness of 
man by which he has conquered nature and his enemies, and has 
explored, investigated, and accomplished all his active achievements 
in the world, so what we see as fears and phobias are only the 
remnants and almost random residua of man's passivity and 
plasticity, which have from the beginning made him receptive and 
docile, which have culminated in the development of memory and 
science, and which began in adjustments to the ways of nature and 
of the social environment. This change is one of the most preg- 
nant of all the insights of genetic psychology, and shows us how 

s Nervose Angstzustande, zweite Aufgabe, 1912. 



74 THE TECHNIQUE OF PSYCHOANALYSIS 

knowledge is itself so largely a product of fears (which culminate 
in the fear of death) and their correlate, the love of life. Each of 
them has innumerable degrees and of these art and religion, no less 
than hygiene and science, are the results, for all of them are but 
progressive realizations of the ever more patent possibilities of 
human nature with all its still slumbering and yet to be evolved 
latencies." 

This is not yet the place to go more fully into those mechanisms 
which Freud has termed hypochondriacal anxiety, social anxiety 
and religious anxiety, sense of shame, etc., nor to show how they 
are pragmatic hypotheses to explain how the sense of individuality, 
ego-consciousness, is moulded — nor how the great work of repress- 
ing the infantile partial libido trends into the unconscious is ac- 
complished. 

^^ The infantile mind has little comprehension of death. HalP has 
compressed the psychoanalytic results when he writes "The psy- 
chology of death has very much in common with that of love, espe- 
cially from the new genetic and psychoanalytic viewpoint. Each 
has an unenvisagable fact at its core as a point of departure, the 
one a putrefying corpse, the sight of which started Buddha on his 
career, the other the sex act ; the one the most horrid, the other the 
most ecstatic of all human experiences. The inutterable psychalgia 
of the one and the shame and modesty that veil the other have in 
both cases made and used the same mechanisms, such as fetishisms, 
diversion, repression, over-determination, sublimination, etc., and 
by their action from each of these cores have evolved the most 
manifold and elaborated superstructures that have played a tre- 
mendous role in human culture. There is a sense in which all fears 
and phobias are at bottom fears of death or of the abatement or 
arrest of vitality, and also a sense in which all desires and wishes 
are for the gratification of love. The one is the great negation, 
and the other the supreme affirmation of the will to live. Orienta- 
tion toward these two poles of experience is not innate in the sense 
of being finished and operative at first but is quite gradually ac- 
quired. The real meaning of death is not understood until puberty 
but both death and love show fragmentary and generally at first 
automatic outcrops from early infancy on. Freudians have shown 
how love has its artistic expressions in the forms of infantile re- 
flexes, almost from the first, and we will first attempt to point out 
how far analogous prerepresentations occur in children with respect 

6 Loc. cit 



TRANSFERENCE AND ITS DYNAMICS 75 

to death. Fear of death is only the obverse of the love for life and 
together they constitute the struggle to survive." 

"The development of the fear of death or thanatophobia in 
children is a striking case of recapitulation. The infant, like the 
animal, neither knows nor dreads death. The death-feigning in- 
stinct in animals is only catalepsy, and the horror of blood that 
some herbivora feel is not related to death. From Scott's 226 cases 
and HalFs own 299 returns to questionnaires, it appears that the 
first impression of death often comes from a sensation of coldness 
in touching the face or hands of the corpse of a relative, and the 
reaction is a nervous start at the contrast with the warmth which 
cuddling and hugging were wont to bring. The child's exquisite 
temperature sense feels a chill where it formerly found heat. Then 
comes the immobility of face and body, where it used to find prompt 
movements of response. There is no answering kiss, hug, pat or 
smile. In this respect sleep seems strange but its brother, death, is 
still more strange. Often the half-opened eyes are noticed with 
awe. The pallor, shroud, and especially coffin are often focused 
on fetishistically, the latter being a strange bed. The friends are 
silent and tearful, and the infant who has been permitted such 
scenes often turns away, perhaps almost convulsively, to whomever 
holds it, as if in fright. The crying, however, seems more reflex 
than ideational. Older children of from two to five also are very 
prone to fixate the accessories of death, often remembering the 
corpse but nothing else of a dead member of their family. But 
our data suggest that funerals and burials are even more vividly and 
often remembered. Sometimes these scenes are the very earliest 
recollections of adults. The memory-pictures of these happenings 
may be preserved while their meaning and their mood have com- 
pletely vanished, and but for the testimony of their elders children 
would not recall later who was the center of it all. Henceforth 
the dead is simply an absentee, and curious questions are asked as to 
where the departed has gone, when will he return, why cannot the 
child go to pr with him. The infantile mind often makes strange 
mixtures of its own naive constructions and adult answers. The 
distinction between psyche and soma, of which death is often the 
first teacher, is hard for the realistic mind of children to make. 
Told that Papa or Mamma sleep or rest in the ground, they ask why 
there, where it is so cold and dark, why they do not wake, what 
they eat, and who feeds them, impulsions that primitive burial cus- 
toms often elaborately answer by preparing bodies for re-animation. 



76 THE TECHNIQUE OF PSYCHOANALYSIS 

leaving food, and utensils, with the corpse, etc. When told of 
Heaven above children have strange crass fancies, perhaps that the 
body is shot up to Heaven, the grave dug open by angels, or the 
body passed dov^n through the earth and then around up; the body 
generally gets out of the grave and goes up to Heaven by night, 
etc. As the idea of soul begins to be grasped, it is conceived as a 
tenuous replica of the body hovering about, sometimes seen, though 
rarely felt. It may be talked to or fancied as present though un- 
seen. Children's dreams of the dead are vivid but rarely dreadful. 
In general the child thinks little or nothing but good of the dead, 
and the processes of idealization, aided by relatives, may almost 
reach the pitch of canonization. The memory of a dead parent 
barely recalled may become a power shaping the entire subsequent 
life of sentiment, as if all the instincts of ancestor worship could 
focus on an individual parent. Some adults maintain quiet sacred 
hours of ideal communion in thought with their departed loved 
ones, and their yearnings make a favorable soil for the ghost cult 
of spiritism. This component of our very complex attitude to dead 
friends is also the stratum which crops out in the holy communion 
sacrament of the ghost-dances of our American Indians, in which 
the souls of all the great dead of the tribe are supposed to come 
back and commune with their living descendants. Just in propor- 
tion as the dead are loved does death work its charm of sublima- 
tion and idealization, and just as a child of either sex has loved the 
parent of the other sex, will he or she idealize a chosen mate 
snatched away by death. Thus, too, one factor in the belief in 
immortality is love, that must conserve its object though deceased, 
this factor being quite distinct from the transcendental selfishness 
that would conserve one's own ego." 

" On the other hand, young children often seem rather to rejoice 
at than to fear death. The excitement of all its ceremonies is 
intensely impressive and new. Some children naively express the 
wish, after a funeral is over, that someone else would die. They 
play funeral, striving with each other who should assume the central 
role of the corpse, which they feign well. One four-year-old tried 
to kill a younger mate and several abnormal children have actually 
done so, in order to enjoy again the excitement of the death, 
funeral and burial. A sweet young girl was found dancing on the 
grave of her baby sister, chanting, ' I am so glad she is dead and I 
am alive,' suggesting, not the ancient days of famine when every 
death left more food for those who survived, so much as jealousy 



TRANSFERENCE AND ITS DYNAMICS 77 

at the diversion of parental attention and care to the younger child. 
Neurotic children often play with unusual abandon, as if to com- 
pensate for the depression, when they have just left the room where 
parents, brothers or sisters have breathed their last. Small boys 
who lose their fathers say, * Now I will milk, cut wood, bring up 
coal' and sometimes they put on the father's hat or shoes, and in 
many ways assume his role, while little girls whose mothers die 
become more tender to their fathers and the other children, feeling 
themselves in some degree the surrogate of the mother. Just as 
children of tender age far more often fear the death of others they 
love than they do their own, so they vastly more often wish the 
death of others they hate than they feel any suicidal impulses. The 
death-wish, once fully felt and realized in consciousness, may, in 
neuropathic children, set up a prolonged and morbid corrective 
process to strangle it, and psychoanalysis has given us many cases 
where over-tenderness to a parent or relative, so insistent as to 
become troublesome, was motivated by the impulse to atone for a 
vivid wish of death, which the child may have made toward the 
object of anger. Only relatively late is the death-wish generally 
directed towards enemies and the ambivalent life-wish reserved for 
friends. Even in the most highly evolved emotional lives this is 
only a question of preponderance, for if our analysis is not mis- 
taken, there never was a death, even of a lover, that did not bring 
some joy to the survivor, swallowed up though this component be 
in grief. Were this not so, comforters and consolations would be 
no resources. We strive to think our dear ones are happier and 
more at peace, console ourselves first with precious memories, and 
then ascribe superior powers of transcendental enjoyment to the 
dead, v Conversely, no savage ever killed the bitterest foe of his 
tribe without elements of pity and efforts to atone to the soul of the 
victim or his friends by saying propitiatory words or performing 
placatory rites. Even Hell and devils never kill the soul and there 
are spots and spells of remission of torment so that surcease and 
nepenthe are not unknown even in the inferno." 

" When children are realizing at the most rapid rate what adult- 
hood means, they often have very serious struggles with a more or 
less intermittent but at times overpowering sense of their own 
Minderwertigkeit, insufficiency, or in completeness, in the sense of 
Janet and Adler. Tolstoi has given us a vivid characterization of 
this impulse in a record of his own boyhood. His tutor flogged 
him, and he reacted as the only way in which he could " get even " 



78 THE TECHNIQUE OF PSYCHOANALYSIS 

by not merely the thought of suicide but the vivid imagination, well 
set in scene, of himself dead and his father dragging the terrified 
tutor before the beautiful corpse, and accusing him of having been 
his murderer, while the friends around bemoaned him as so brilliant 
yet so tragically driven to death." 

We are getting nearer to a comprehension of what transference 
means as a very strong unconscious libido flow to afford to the indi- 
vidual a sense of security; to drive away any fear that is related 
to death (impotency in the large sense). 

We shall come to see that transference starts very deep in the 
unconscious. It grips from the most primitive libido foundations, 
but I think it worth while as a practical issue to follow it at a more 
superficial stage ; i. e., a stage to which it evolves after the infantile 
period. If the mode of expression of the libido of the individual at 
this stage is grasped we can later push it further back. 

Adler^ has made a special study of this phase of the problem. 
No complete presentation of his views is as yet available in English, 
hence a very brief summary may be considered worth while as bear- 
ing on the general problem of psychoanalysis and on the compre- 
hension of transference. I myself found that certain features of the 
transference and resistance of patients' dreams were incompre- 
hensible until Adler's views were better known to me. 

Adler was dissatisfied, as many others have been, with the cur- 
rent conceptions of disease of all kinds. They were beautifully 
descriptive but not at all genetic. He was anxious to get away from 
the benumbed and thwarted conceptions of disease and to be able 
to observe human pathology in the making. 

The reading of any work on pathology, so far as the etiology of 
disease is concerned, consists of a short collection of truisms. Such 
terms as chill, predisposition, poisons, infections, disturbance of 
circulation, appear and reappear. Nowhere is there any real com- 
prehension of these causal factors themselves. Nowhere does any 
pathology say, why for instance, in scarlet fever, this patient or 
that has implications of the middle ear Sf the kidneys. Why do 
certain things evolve in certain organs and not in others. Adler 
casts himself loose from the ordinary static positions and en- 
deavors, by a study of a number of cases with defective urinary 
apparatus, to show that in the first place there is an effort on the 

"^ Adler, Studle iiber die MInderwertigkelt der Organen, 1907, now avail- 
able in translation, Monograph Series No. 2Z, 1916. Nervosa Charactere, 1913. 
English translation by Gliick and Lind, Moffat't, Yard & Co., New York. 



TRANSFERENCE AND ITS DYNAMICS 79 

part of the individual to evolve to a higher form and each one does 
it by some supreme effort to physically compensate for the organic 
inferiority. He thus gets at a genetic view of human evolution 
through its phylogenetically inferior organs. So he regards con- 
stitutional organic anomalies at the basis of most diseases. - This 
inferiority is registered in the unconscious and evolves to a feeling 
of psychical inferiority. Incidentally I take it that Southard in his 
extensive series of studies on human brains is endeavoring to show 
that such organ-system inferiority may actually be registered in 
brain structure as determined by macroscopical and microscopical 
methods. He thus is approaching the problem from another angle. 

This unconscious psychical inferiority gives rise to unconscious 
compensatory phenomena. These are character traits — so often 
explained on a conscious basis, but which are vast constellations and 
in need of individual analysis. Yet they have been of sufficient 
symbolic value to have caused that immortal line " O wad some 
power, the Gift to gie us," etc., to have found universal credence. 

This work of compensation, as Adler outlines it, is well sum- 
marized by Hall.^ " Every subnormal [minderwertige] organ is more 
plastic and adaptable than normal organs or functions. Under the 
stimulus and protection of the central nervous system when it has 
taken the helm they may become not only the more variable in other 
ways but may even become supernormal. What is more important, 
they may be compensated by other organs or functions with which 
they are correlated. Moreover, superstructures are built which 
vicariate for them, supplementing their deficiencies. Thus recalling 
that man is a congeries of many organs in various stages of evolu- 
tion and decline, the nervous ssytem when it comes to power estab- 
lishes a set of interrelations between those that are essential under 
the will to live. Leaving some to decline and powerfully stimulat- 
ing others to unfold and develop, by keeping them sufficiently but 
not too much in exercise, it reinforces both atrophy and hyper- 
trophy. In the effort of the psyche to foster the important organs 
and functions which it selects for its special care, organic defect 
may be compensated by excess of nervous activity. Indeed, most 
compensations are in the psychic though not necessarily in the con- 
scious field. No one is perfect, and hence compensation is neces- 
sary for all. It makes for, if indeed it does not make, conscious- 
ness itself. Those organs and functions which the psyche cannot 
directly or indirectly control decay or become stigmata. Where the 

8 Hall, 1. c. 



80 THE TECHNIQUE OF PSYCHOANALYSIS 

brain fails to establish a compensatory system we have all the hosts 
of neuroses and psychoses. The existence of sub- or abnormal 
organs or functions always brings Janet's sense of incompleteness 
or insufficiency, and this arouses a countervailing impulsion to be 
complete and efficient which those to whom nature gave lives of 
balanced harmony do not feel. The ideal goal is always to be a 
whole man or woman in mind or body, and this may crop out in 
the childish wishes that are sometimes fulfilled in dreams, in the 
ambition of the boy who aches to be a man, and in general in the 
desire to overcome all defects and to evolve a full-rounded, mature, 
powerful and well-balanced personality. To illustrate, each bi- 
lateral organ compensates for defect in the other, one sense for 
another like touch for sight in the blind. Mozart had an imperfectly 
developed ear ; Beethoven had otosclerosis ; Demosthenes stammered 
and, as if mythology had recognized this law, many of the ancient 
gods were defective. Odin had but one eye; Tyr, one hand; 
Vulcan was lame; Vidar dumb. So, too, the ugly Socrates made 
himself a beautiful soul. A man with a weak digestion becomes a 
dietetic expert in battling with fate. Little men walk straight; tall 
men stoop. Handsome men are superficial. A subnormal eye in- 
tensifies the visual psyche. In the effort to control enuresis due 
to renal insufficiency over-compensation may predispose to even 
dreams of water. Sex weakness is supplemented by fancies of 
superpotence. Many diseases have compensating forms with which 
they alternate or for which they vicariate and the very principle of 
immunization is involved. Weak parts and functions draw atten- 
tion and are invigorated thereby. Fear of an object excites interest 
in it and this brings the knowledge that casts out fear. Very much 
of the total energy of all of us and still more of that of neurotics 
and psychotics is spent in developing and using devices of conceal- 
ment [Deckphenomene] of diseases and defects. Thus often the 
higher protective and defensive mechanisms come to do the work 
of the subnormal function even better than it would do it. Con- 
versely compensation has its limits and when it breaks down we 
have anxiety, the most comprehensive of all fears and the alpha and 
omega of psychiatry, the degree of which is inversely as the ability 
to realize the life-wish of self-maximization. It involves a sense of 
inferiority, inadequacy and greater tension. The goal may be the 
humble one of self-support, normality, merely absence of actual 
pain, or deformity, but the prospect of failure to attain it brings a 
distress probably equalled by no other form of suffering and every 



TRANSFERENCE AND ITS DYNAMICS 8 1 

fear is a special form or degree of it. If the good, strong, healthy, 
higher components can neither improve nor atone for the bad, weak, 
low or morbid elements, anxiety, conscious or unconscious, super- 
venes, values lose their worth, we tend to take refuge from reality 
in fancies, and innate momenta are arrested and we suffer we know 
not what, perhaps fear itself." 

All this and more is going on in the unconscious. The patient 
with a neurosis is searching for a sense of security — " Sicherung " 
as Adler terms it. Here is where the CEdipus formula comes in. 
They find it in the parental images — in the unconscious. Hence 
they seek in the physician the same parental image in order to get 
the sense of security. It is much disguised, it is true, but neverthe- 
less there. It is an unconscious attachment (positive transference), 
or denial (negative transference), with many currents and counter- 
currents. 

Dynamically this transference is at the basis of all psychotherapy 
— and much pharmacotherapy. As Osier put it for the latter 
" Without faith in our pills they would avail the patient little, apart 
from the bare half dozen known specifics." 

The first fundamental studies of transference were given us by 
Freud^ and by Ferenczi.^^ 

Freud here discusses how the use of the dream can help the 
analyst to watch the transference, the barometer of the patient's 
unconscious hopes and discouragements, his desire to get security, 
his disapproval if he thinks he fails. 

The first dream of the patient is extremely important. As 
Freud says if this is neglected one may have to retrace one's steps 
very definitely in order to catch up the patient's interest. 

Let me illustrate. The following dream was that of a young 
woman of 32 who was suffering from a mild depression, a sense of 
unworthiness and of failure. *' / was in a room and on a balcony, 
to my left was a man dressed in a Roman toga, talking Chinese) 
and preaching a Hebrew religion/' The ideas which free associa- 
tion brought out of this dream were very diverse but from them I 
learned, for myself at any rate, that the patient did not understand 
what I was talking about, that her unconscious was commenting on 
the choice of my words and of my ideas. She had learned a little 
concerning the nationality of Freud and the whole discussion of the 

9 Zur Dynamik der Uebertragung, Zentralblatt f iir Psychoanalyse, Vol. 
II, p. 167. 

10 Intro jektion und Uebertragung, Jahrbuch I, 1913. 



82 THE TECHNIQUE OF PSYCHOANALYSIS 

subject was Chinese to her. I had evidently set forth too much in 
explanation. The analysis of my own resistances taught me to come 
down from the balcony and try to understand her better. 

Another first dream is related by a woman of forty. This dream 
took place after the second interview. The patient had previously 
stated that she never dreamed and on the second visit she laughingly 
said " Well, I did dream, but I only recall a fragment of it." " Ap- 
parently I was on a golf course and Dr. X. was hit on the side of 
the head with a golf hall.'^ Her first association saying in answer to 
my question, Did the dream convey any idea to you? was that it 
meant nothing, but Dr. X., her brother-in-law, married to a younger 
sister, was one of those new golfers that always wanted to get ahead 
so fast and did not wait until the players had all driven. 

From this I learned very quickly that among other things she 
gave me a sharp rap on the knuckles for going so fast. The re- 
sistance was analyzed on the spot, and matters went along slower 
but more securely. 

Freud has called these "announcement dreams."^^ They often 
serve to tell the analyst what the patient's first unconscious impres- 
sions are concerning him, and they also often announce the whole 
character of the conflict. This is true particularly for those patients 
whose conflicts are often half grasped (foreconscious). The fol- 
lowing is an illustration: 

The patient, twenty-eight years of age, whose chief complaints 
were persistent headaches at the back of the head, a sense of great 
tenseness, a marked trend to suffusion of the face, pathological 
blushing, with a host of transient gastro-intestinal and other phe- 
nomena, at the second interview related : '"'' / am on a bleak hillside, 
there is a threatening cloud coming up from the valley. I am with 
a little girl; I am anxious to get seven or eight little hooks into the 
house where they will not he destroyed, and we bring them in and 
put them on the washstandf 

My first question was (Why "or eight?") To which the reply 
was " I do not understand." I then said : " What are books to you ? " 
Books, stories, life histories, life experiences. These were the as- 
sociations. (And washstands?) Something to clean, to wash. 
And I replied, " You wish to tell me [the threatening cloud] about 
seven life experiences which you have had in order to cleanse them 
and be cleansed by the telling of them [confessional motive], and 
the eighth is just formative, and that is why you said or eight." To 

11 Maeder, Jahrbuch, Vol. IV, page 692. 



TRANSFERENCE AND ITS DYNAMICS 83 

which a reply was made. "Yes, I think that I have made up my 
mind that you can help me, and it seems necessary that I should be 
able to find some one to trust and to tell what is constantly in my 
mind, and which keeps me distressed all the time." 

Here the transference put me in the place of a father confessor 
and announced at the same time, even in the upper level of the 
dream, there were seven or eight unworthy experiences which had 
to be gotten rid of to get at the deeper levels of the conflict. This 
dream, also by reason of its compactness — overdeterminism — an- 
nounced epochal periods of the patient's life with reference to con- 
flicts occurring at the age of 7, at 8, at the age of the little girl in 
the dream 15 (7 + 8=15) and I was also able to make a shrewd 
inference of the nature of the ''or eight'' experience (5 X 3=i5)» 
mutual masturbation symbol. This had occurred at 7, 8, and at 15, 
and was the stage of the ''or eight'' experience. Concerning these 
numbers in dreams, however, I shall delay saying anything until I 
discuss the question of the technique of dream interpretation. 

Thus even with no great technical elaboration it may be seen 
how an early dream will announce the whole situation, and also 
indicate where the analyst stands in the patient's wish to get well 
(cleansing symbol = wish for ethical rehabilitation). 

Another illustration may also indicate this early announcement 
of the conflict and the patient's formulation as to how the uncon- 
scious portrays the analyst. It may be said here, as a preliminary, 
that it is very frequent to find that the dream very soon pictures the 
analyst by some characteristic feature. I myself am large and stout 
— 5° 10', 200 pounds, clean shaven, with a roundish face. Hence 
it is clear why I should appear with great regularity, especially in 
the early stages of an analysis — before the patients perceive how 
they are telling their innermost thoughts — as a policeman, a motor- 
man, a chauffeur, a priest. The simpler the type of mind the less 
am I disguised. Each analyst will by a careful review of himself 
soon learn to recognize the more obvious symbols of himself. Later 
on the analyst goes deeper and deeper into the patient's conflicts 
with the infantile pleasure principle and as the analysis threatens to 
reveal these to the patient in uncomplimentary forms, the disguises 
become more or less subtle and often not at all flattering to the 
analyst. The analysis of the patient consists, however, in the com- 
prehension of these resistances which frequently hide behind these 
unflattering pictures the peculiarities of the analyst himself. Thus 
the transference becomes an exquisite sensitizer, which rightly used 



84 THE TECHNIQUE OF PSYCHOANALYSIS 

compels the analyst to search his own complexes and resistances 
and forces him to keep the goal in view — ^that is the patient's best 
interests and not his own gratification or glorification, financial or 
otherwise.^^ 

The next example, fragmentarily presented, is taken from the 
history of a young married woman, twenty-six years of age, who 
had had two miscarriages, and who, much reduced in weight, had 
lost all interests in everything, had a number of hysterical conversion 
signs, among them an intense acne around the mouth and chin and 
left cheek, insomnia, vomiting, etc. She dreamed : 

"I am all alone on a desert island [wish for lack of conformity 
to social demands] Hawaii, Honolulu, or what not [wild infantile 
libido] . / was told that I would meet every one I loved on the Island 
[early wish source]. / met my mother [first nutrition object and 
first determiner for mouth location of wish = acne] and she was 
very sad [identification of own state]. Her husband did not love 
her any more [detachment of patient's own libido from husband — 
for nutritive and other defects]. / met a cousin of mine with two 
lovely children [own missed opportunities] and she was very happy. 
She asked me why I was so sad, and I said because my father did 
not love my mother any more and she said [sad self vs. happy self] : 
if you believed in Yogi, as I do, you would be happy [transfer symbol 
and wish for recovery] . The dream then went on to a discussion of 
the relative values of God in whom patient believed, and Yogi in 
whom cousin believed. 

As the dream is being used solely to illustrate one point, namely 
that of the beginning of the transfer situation and the announcing 
of the conflict, I shall not go into it deeply. The discussion meant 
that the patient was trying to decide to tell Yogi [myself = the 
wise man, new religion] what lay between her and God, i. e., what 
only God and she knew. This was that she no longer loved her hus- 
band. There had occurred therefore a deep regression of the libido, 
back to the wild, infantile wishes which would supply her sexual 
and nutritive instincts and how was she to get away from what 
seemed to her an intolerable position. She therefore was prepar- 
ing herself to see if there was not some — even occult — way of 
getting well, and that possibly psychoanalysis, concerning which she 
had some crude ideas that it might have some mystical leanings 
which — she did not even consciously know there was such a word 

12 Jelliffe, Some Notes on Transference, Journal of Abnormal Psychol- 
ogy, Vol. VIII, No. 5, p. 302. Also see discussion, page 346. 



TRANSFERENCE AND ITS DYNAMICS 85 

as Yogi — would help her. I had said nothing to her of psycho- 
analysis, but in the first visit I had gone very thoroughly into all 
the minutiae of her case. Following this dream she wrote out a 
detailed history of the entire surface features of the conflict, describ- 
ing all her aspirations concerning marriage, its keen disappointments, 
an earHer engagement with a vigorous, energetic individual (Hawaii, 
Honolulu — his name began with H), the direct antithesis of a "good 
and worthy" husband. 

The favorable attitude of the unconscious wish (if you believed 
in Yogi you would he happy) showed an early desire to follow the 
therapeutic ideas which were more rapidly developed after this ini- 
tial tender of confidence. 

I shall not go further into the dream, but I may say that if it 
seems desirable almost any dream will contain the entire conflict of 
the individual. 

As Steckel has well said : " The dream is a microscopic world, 
which reproduces in miniature the whole psychic world."^^ *- 

These few examples offer some illustrations concerning the 
more positive side of the beginning of an advantageous position for 
the analyst. A few of the negative types in the beginning of an 
analysis may be equally of service, as indicating wherein one is 
not making ground. It must be borne in mind by any one who is 
working with psychical material, that fundamentally people are much 
alike; the unconscious, containing a racial recapitulation (inher- 
itance) of one hundred million years is very much on a par all 
around. 

I frequently illustrate this to "my patients by saying that the 
entire active life of the individual may be represented by a frac- 
tion, the numerator of which is any particular moment, the denomi- 
nator is the rich inheritance of the past. Psychology and most rea- 
soning has heretofore concentrated its attention on the numerator, 
and has made it appear to be the active life. Conscious knowledge 
has been made the criterion of man's entire activity. The de- 
nominator, which is infinitely more extensive and more important 
is either neglected entirely, or vaguely spoken of as intuition, in- 
stinct, temperament, personality, feeling, and the individual who 
thinks he or she is different is spoken of as " psychic " or by some 
other such term. Behind these phrases, however, there lies the 
whole of the unconscious material that has been accumulating since 
cosmic forces first began their careers. It is the " As it was in the 

13 Steckel, Die Sprache des Traumes, 191 1, Bergmann. 
7 



86 THE TECHNIQUE OF PSYCHOANALYSIS 

beginning, is now and ever shall be, world without end, Amen." 
This is the material, the soul, or desire or wish^* part of action with 
which psychoanalysis deals. It is interested in denominators, and 
the analyst only listens to numerators for the purpose of reading 
behind the scenes since he knows that every consciously expressed 
opinion is always a compromise, a resultant of forces in a polygon 
of forces. It never is the entire truth. Perhaps the psalmist was 
not so far wrong when he said " All men are liars." 

" Consult E. B. Holt', The Freudian Wish, H. Holt & Co., N. Y. 



CHAPTER VI 

Transference and Resistance. Opposing yet Identical 
Mechanisms. Practical Signs 

It is to be remembered that a neurosis, no matter how slight — 
and no one is absolutely free of some minor neurotic symptom — 
is an indication of a failure to get some energy (libido) released for 
the socially valuable use of the individual, hence every neurotic has 
what Freud has so well termed floating libido — a libido that fails to 
attach itself to a reality motive and thus fails to satisfy the indi- 
vidual (sense of power). They are, so to speak, always looking for 
something. This is frequently spoken of as the ideal part of the 
neurosis, the essentially moral or ethkal urge that, finding it difficult 
to accept the inflexibility of the environment of the individual setting 
(herd) tends to regressively accept, often with extreme reluctance, 
an earlier stage of adaptation. 

In every individual's growing up these definite stages of satis- 
faction of the wish life, the love life, are reached and passed for 
others; as Tennyson puts it, "We rise on stepping stones of our 
dead selves to higher things." The stepping stones, however, have 
always the aspect of stopping places. Those who do rise, do so by 
fitting into reality, those who do not, remain in fantasy, and the 
mosaic of character is a fascinating and intricate patchwork of these 
dynamic factors, conscious and unconscious. 

Thus in any form of therapy, for it is not confined to psycho- 
therapy, the patients turn expectantly to every new person (physi- 
cian, healer or what not) for the floating libido hopes to find in the 
new object its satisfaction, conscious (small numerator) as well as 
unconscious (large denominator). 

In the previous discussion of the family neurotic romance, p. 54, 
et seq., I have described some of the types of ideals that have been 
formulated. Hence in the new situation the physician is fitted 
into any one of the psychic series. The unconscious fear situation 
elaborated in the last series of remarks, immediately involves the 
physician with immensely over-dynamized protective capacity. He 
becomes father image, brother image, mother image, etc. 

Freud in his " Dynamics of the Transference " calls attention to a 
point that might be considered here. He points out two unexplained 

87 



88 THE TECHNIQUE OF PSYCHOANALYSIS 

features of the transference which are of especial interest to the 
psychoanalyst : First, whether in the analysis of neurotics the trans- 
ference is found to be much stronger than with those unanalyzed, 
and second, why the transference appears as a strong resistance to 
the treatment. As to the first question it is not true that in psycho- 
analysis the transference is more intense and unrestrained than in 
other forms of therapy. One observes in institutions, where nervous 
diseases are treated without analysis, the highest intensity and the 
most unworthy forms of transference amounting even to subjection 
and also the most downright erotic coloring of the same. These 
features of the transference are not to be ascribed to psychoanalysis 
but to the neurosis or psychosis itself. 

In my own studies in the history of psychiatry I find abundant 
proof of this from the earliest Homeric descriptions to the present. 
This renders stupid the contentions of many authors that psychoanal- 
ysis creates the symptoms. One might just as well argue that seeing 
a nude created the instinct of reproduction. While I am writing 
this I have been telephoned to by a fellow physician (a Janus-faced 
Freudian) who has seen a patient I had seen for five times the 
month previous. For perfectly well understood economic reasons 
I could not treat the patient. He started to tell me that psychoanal- 
ysis (which had never been started) was responsible for the pseudo- 
erotic coloring of her symptoms. I dryly suggested to him to in- 
form himself from Dr. X (a general practitioner) who had treated 
the patient six years previously, at which time she was actively 
elaborating highly erotic situations. It is by no means infrequent 
that a patient who is going into a psychosis is seen by the analyst at 
just this period. The acute breakdown which soon becomes evident 
is frequently attributed, and often by those who ought to know 
better, to analysis. It is just as sensible to say that the giving of a 
pill by an internist to a patient just starting a typhoid, caused or 
precipitated the typhoid. 

With reference to the second problem, why the transference 
should appear in the psychoanalysis as a resistance — which is an 
intensely vital subject — Freud calls attention to the fact that a 
regular and indispensable previous condition in every case of psycho- 
neurosis is the condition which Jung has well named the intro- 
version of the libido, that is to say, the portion of the libido capable 
of consciousness and turning toward reality is diminished. That 
portion of it turned away from reality, unconscious, which may per- 
chance still feed the phantasy of the individual, but belongs to the 



TRANSFERENCE AND RESISTANCE 89 

unconscious, is so much the more increased. The libido because of 
some definite relation to the external world (in general, failure of 
satisfaction) has given itself over entirely or in part to regression 
and reanimated the infantile images. Upon this follows the ana- 
lytic treatment which searches out the libido to make it again acces- 
sible to consciousness and serviceable to reaHty. Where the ana- 
lytic search strikes upon the libido withdrawn into hiding, a con- 
flict must break out, all the forces which have caused the regression 
of the libido will rouse themselves as "resistance" against the 
work, in order to preserve the existing condition of affairs. 

The resistances of this origin are not the only ones nor by any 
means the strongest. The libido at the disposal of the personality 
has always stood under the attraction of the unconscious — more cor- 
rectly of those portions of the complex belonging to the unconscious 
— and it found its way into the unconscious because the attraction of 
reality had abated. In order to free it this attraction of the uncon- 
scious must be overcome, also the repression of the unconscious in- 
stincts and their productions hitherto existing in the individual must 
be released. This furnishes by far the greater part of the resistance, 
which so frequently allows the disease to continue even if the turn- 
ing away from reality no longer has the same foundation. The 
analysis has to struggle with the resistance from both sources, re- 
sistance that accompanies the treatment at every step. If one fol- 
lows up a pathogenic complex from its representation in conscious- 
ness to its root in the unconscious one soon comes to a region where 
the resistance makes itself so clearly felt that the next step must 
reckon with it and appear as a compromise between its claims and 
the investigation into it. 

If perhaps something of the material (content) of the complex 
is suitable to be transferred to the person of the physician, there the 
transference arises, furnishes the next idea and announces itself 
through the symptoms of the resistance, perhaps through an obstruc- 
tion. It may be concluded from this experience that this idea of the 
transference has therefore succeeded before all other possible ideas 
in consciousness because it has also satisfied the resistance. Re- 
peatedly if one touches upon a pathogenic complex the part of the 
complex prepared for the transference will be pushed into con- 
sciousness and defended most stubbornly. 

After overcoming this the conquest of the other factors of the 
complex gives but little difficulty. The longer analytic treatment 
lasts and the more clearly the patient recognizes that the distortion 



90 THE TECHNIQUE OF PSYCHOANALYSIS 

of the pathogenic material offers no protection against its uncover- 
ing, so much the more self-importantly he avails himself of the one 
mode of distortion which plainly brings him the greatest advantage, 
the distortion through transference. These relations take the direc- 
tion of the situation in which all conflicts must be fought out in the 
territory of the transference, and the transference appears to be 
the strongest weapon of the resistance, while the intensity and per- 
sistence of the transference are effects and expressions of the re- 
sistance. The mechanism of the transference is adjusted through 
leading it back to the preparedness of the libido which has remained 
in possession of infantile images ; the explanation of its role in the 
treatment is successful only if one enters into its relations to the 
resistance. 

How does it happen that the transference is so preeminently 
adapted as a means for the resistance? It is clear that the confes- 
sion of every forbidden wish impulse is made more difficult if made 
before the person who himself is the incitor of the wish. On the 
other hand a relationship of tender, self-surrendering dependence 
can help over all the difficulties. The transference to the physician 
may just as well serve for the discharge of the confession and not 
increase the difficulty. 

The answer to these questions will not come through further 
deliberation but through experience acquired in the research into 
individual transference and resistance. The utilization of the 
transference for the resistance cannot be understood so long 
as one thinks merely of the "transference." One must decide to 
separate a "positive" from a "negative" transference, that of an 
affectionate feeling from a hostile one, and to treat both kinds of 
transference upon the physician separately. The positive transfer- 
ence separates itself into such friendly or tender feelings, which 
are capable of consciousness, and into the continuation of them into 
the unconscious. Of the latter the analysis furnishes proof that 
they regularly go back to infantile sources, so that the insight is ob- 
tained that all our worthy relational feelings are genetically bound 
up with the generative instinct, that the merely cherished or honored 
person of our reality can be for our unconscious always a love 
object. 

The solution of the problem is also that the transference to the 
physician adapts itself to the resistance in the treatment only in so far 
as it is negative or positive transference from repressed erotic im- 
pulses. If we "raise" the transference by bringing it to conscious- 



TRANSFERENCE AND RESISTANCE 9I 

ness only these two components of the emotions are detached from 
the person of the physician. The other component capable of con- 
sciousness and harmless remains and is the bearer of the result in 
psychoanalysis as in other therapies. So far it is freely admitted 
the results of psychoanalysis may be comjpared to suggestion; only 
under suggestion must be understood what Ferenczi^ finds in it, the 
influencing of a person through the transference phenomena pos- 
sible with him. We are careful while using suggestion for the 
final self-understanding of the sick to allow it to complete a psychi- 
cal work which has for its necessary result the lasting improve- 
ment of his psychical situation. Suggestion and hypnotism ^ then 
are simply crude and more or less empirical ways of utilizing the 
dynamic principle of transference. This I shall develop later. 

It may yet be asked why the resistance phenomena of the trans- 
ference appear only in psychoanalysis and not as well with indiffer- 
ent modes of treatment in institutions. The answer is that they mani- 
fest themselves there also, only they have not been valued as such. 
The breaking out of a negative transference is frequent in institu- 
tions as it is in all medical circles. The constant changing of physi- 
cians in ordinary practise is due to resistances. The patient leaves 
an institution or a physician, unchanged or subject to relapse, as soon 
as he falls under the sway of the negative transference. The erotic 
transference works less obstructively in institutions since there, as 
in ordinary life, it is attenuated and extenuated instead of uncov- 
ered. But it manifests itself quite clearly as resistance against 
healing, not because it drives the patients from the institution — it 
keeps back part of them^ — ^but in this, that they keep it. It is imma- 
terial for the cure whether the patient in the institution overcomes 
this or that anxiety or hindrance, it is much more important that he 
becomes free from it in the reality of his life. 

In the forms of psychoneuroses amenable to treatment the neg- 
ative transference is found close to an affectionate transference di- 
rected often at the same time toward the same person, for which 
Bleuler has coined the excellent expression, ambivalence.^ In a cer- 
tain measure such- ambivalence of feeling is normal, but extreme 
degrees are certainly characteristic of the neurotic or psychotic. With 
compulsion neurosis an " early separation of the opposites " seems 
to be characteristic for the instinct life and to represent one of its 
fundamental conditions. 

1 Ferenczi, Introjektion und Ubertragung, Jahrbuch fiir Psychoanalyse, 
Vol. I, 1909. 

2 See Bleuler, Schizophrenic Negativism. Monograph Series No. 11. 



92 THE TECHNIQUE OF PSYCHOANALYSIS 

This is however but one side of the transference phenomenon. 
Another aspect must be considered. Whoever has received the 
right impression from these discussions, how the patient analyzed 
is hurled out of his real relations to the physician as soon as he 
comes under the dominion of the fertile transference-resistance, 
how he assumes his freedom then to neglect the fundamental rule of 
psychoanalysis that one shall tell everything without criticism that 
comes to his mind, how he forgets the purpose with which he en- 
tered upon treatment and how now logical connections and conclu- 
sions are indifferent to him, which shortly before made the greatest 
impression upon him, such an one will need to explain the impression 
by other causes than those given here, and such are in fact not far 
to seek. They are furnished by the psychological situation in which 
the treatment has placed the one analyzed. 

In the tracing out of the libido lost to consciousness one is driven 
into the territory of the unconscious. The reactions which an indi- 
vidual carries out throws much light on the character of the uncon- 
scious occurrences, as is learned from the study of the dream. The 
unconscious impulses do not want to be recalled as the treatment 
would have them, but strive to reproduce themselves in accordance 
with the timelessness and hallucinatory ability of the unconscious. 
The patient reacts to the present and reality similarly as in the 
dream, to the results of the awakening of unconscious impulses ; he 
would act out his passions without taking account of the real situa- 
tion. The physician will urge him to enlist these feeling impulses 
with the treatment and in his life history, to bring them in order 
under careful consideration and recognize them according to their 
psychic value. 

This struggle between physician and patient, between intellect 
and instinct life, between knowledge and desire for action, plays 
itself out almost exclusively in the transference phenomena. On 
this field must the victory, whose expression is the permanent cure 
of the neurosis, be won. It is undeniable that the subduing of the 
transference phenomena presents the greatest difficulties to the 
psychoanalyst, but one must not forget that just this demonstrates 
the invaluable service in making actual and manifest the hidden and 
forgotten love impulses of the patient, for no enemy can be slain in 
absentia or in effigy. 

Before taking up the subject of negative transference there is 
one problem of positive transference which the beginning analyst 
must fully comprehend. It is a subject met with in all fields of medi- 



TRANSFERENCE AND RESISTANCE 93 

cine and is not unique in psychoanalysis, but psychoanalysis attempts 
to deal with it and inasmuch as it has its special application in the 
psychoneuroses by reason of the '' floating libido/* of which mention 
has been made, it should be understood. This type of transference 
is almost universally capitalized by the average physician. The situ- 
ation is usually lightly alluded to under the euphemism " the grate- 
ful patient." 

Here, again, as in so many other psychoanalytic problems, Freud 
has had the courage of his convictions and dealt with it. 

This situation, which it must be emphasised is only one of many, 
develops not infrequently. It is the situation in which the patient 
betrays through minute or unmistakable signs or directly confesses 
that like any other mortal woman she has fallen in love with the 
physician who is analyzing her. As Freud has well said this situa- 
tion has its distressing as well as its ludicrous side and it may also 
be said to have its serious side as well. It is at times extremely in- 
volved, depends on a number of different conditions, is occasionally 
unavoidable and always is difficult of solution. Its discussion is 
necessary in psychoanalytic technique. 

First let me illustrate how a strong positive transference may 
almost forecast that this situation is going to arise. After all, the 
best technique endeavors to avoid it, and hence it must be handled 
early. 

This patient, a young unmarried woman of twenty-five, was re- 
ferred to me by a physician who told me " he did not know what was 
the matter with her. She was one of those nervous creatures who 
always made him tired." She had a timid shrinking manner, very 
quiet and furtive, low voice and gentle. She complained of palpita- 
tion and flushing, a sense of faintness, and had several ill-defined 
phobias with anxiety symptoms, chief of which was a sense of 
strangeness. She was much in need of analysis, was clever and 
intelligent and was very anxious to get well, in order not to be 
dependent upon relatives. She had been to many physicians. 

I had seen her four or five times when she brought me a dream 
showing an implied criticism of a relative. It was a typical "mis- 
tress situation." On touching upon a certain aspect, which revealed 
concealment, she said : " Oh, I did not tell you a dream I had the 
first night after I met you. It was this : 

*'''/ thought I saw a picture of a man performing artificial res- 
piration on an Egyptian mummy /^ 

Associations soon revealed that I was the man ; the mummy was 



94 THE TECHNIQUE OF PSYCHOANALYSIS 

a woman and she soon identified the mummy with herself, "her 
feeling of being all dead inside," " her feeling of strangeness." She 
wanted to be brought to life and the method of artificial respiration 
was not far removed in its motive from that which wakened Briinn- 
hllde from her sleep. 

It was apparent that this patient was revealing a strong early 
attachment, as yet unconscious, and, as in the position just outlined, 
What is one going to do about it ? 

To the laymen as well as the outside physician the affairs of 
love occupy a role above all others. Freud writes :^ 

"If the patient has fallen in love with the physician there might 
seem to be three courses open. A permanent, legitimate relationship 
might come to pass, though this would be unusual. Or physician 
and patient should at once separate and give up the work they had 
begun. The third course might not seem incompatible with the 
success of the treatment, namely a temporary illegitimate love rela- 
tionship. 

" The last is at once ruled out by general morality no less than 
by professional propriety, although there have been reports of such 
physicians who create such a situation by at once inviting the patient 
to fall in love for the sake of the treatment." 

This is such a silly procedure as to be recognized as bad technique 
at once. 

" The pursuance of the second named course merely necessitates 
a second analysis with another physician and a further repetition 
of the same situation. This course might appeal to interested rela- 
tives who neither recognize the necessity of the transference as a 
means toward the final cure nor realize that it is as certainly present 
in any sort of therapy, somatic or purely psychical, but concealed 
and unanalyzed in the former and therefore not contributing to re- 
covery as psychoanalysis compels it to be. Such a breaking away 
from the analysis on the part of the patient would effectually reveal 
to the physician that the transference arose out of the neurosis and 
its analysis and was not based upon any personal superiority on his 
part. 

"The physician, however, must see another course than either 
of these two mentioned possibilities. He must guide the patient 
to accept the falling in love as an inevitable fact. There is an im- 
portant point, however, at which the erotic situation due to this cer- 

3 Bemerkungen u. d. Uebertragungsliebe, Int. Zeit. f. Aerzt. Psa., Vol. 
Ill, No. I, 1915. 



TRANSFERENCE AND RESISTANCE 95 

tainly does not appear conducive to recovery. The love situation 
seeks to occupy all the patient's thought and attention. Interest in 
the symptoms is neglected. The patient suddenly even considers 
herself well, and the physician may be deceived as well until he 
comes to appreciate the condition that has arisen as in reality a mani- 
festation of resistance. The former compliance of the patient, ac- 
quiescence in the explanations of the analysis, the understanding and 
intelligence, all are swept away while the patient is absorbed in her 
eroticism. The feeling of love, which has all along been present, 
is now being utilized to draw the analyst from the work of investi- 
gation. For this state of things arises just when a particularly 
painful repressed bit of Hfe history needs to be confessed or re- 
called. 

" The interplay of erotic feeling and resistances is very intricate. 
The unconscious would be satisfied by erotically overcoming the phy- 
sician and would break his authority through his degradation. It 
cleverly intensifies the love and willingness to surrender in order 
to make this in turn something to be guarded against, therefore to 
justify the repression. 

" A simple way out might seem to be for the analyst to place 
now before the patient the ethical demand with its necessity for 
renunciation and exaltation of the ego to the higher planes. Such 
a demand is however too great for the patient at this time. It would 
simply add to the former repression and create in the patient a 
feeling of scorn and desire for revenge. 

" Yet neither can the analyst set himself upon a middle course of 
a moderated affection toward the patient without physical activities, 
until the patient can be brought to a higher plane. No one is suffi- 
ciently master of himself and of circumstances for such an uncer- 
tain course. The educational effect and ethical value of the psycho- 
analytic treatment is rather built upon absolute truthfulness toward 
the patient, which can therefore permit o.f no such temporary devia- 
tion from the true state of the case. 

" The patient could not on the other hand bear an absolute and 
complete denial of all desires. The need and desire constitute the 
driving force for the work of analysis and transformation, and the 
physician must exercise care that these are appeased, though through 
a substitute. Actual satisfaction has long been impossible from the 
very nature of the malady. 

" Any return of tenderness on the part of the analyst toward the 
patient would grant her what she demands, but destroy his authority 



96 THE TECHNIQUE OF PSYCHOANALYSIS 

over her in the problem of treatment and control of the neurosis, 
and so completely overthrow the success of the treatment. The goal 
of the neurotic would be attained, namely to make actual in life the 
phantasies and desires, which should have been reproduced only 
psychically for the analytical work. The hindrances and patho- 
logical reactions would accompany the love as it proceeded, but only 
to strengthen the repression finally without any correction of the 
same. Thus the granting of the love desires is as fatal for the 
analysis as their suppression. 

" The analyst's course must be still another, a unique one. He 
must neither drive away the transference nor must he return it. He 
must firmly grasp the phenomenon as a temporary manifestation 
belonging only to the period of treatment, which must be led back 
to its unconscious sources, an instrument which will thus serve to 
bring into consciousness the most hidden part of the patient's love 
life in order to obtain mastery over it. There must be enough per- 
mission granted to the love to allow the patient to feel herself 
sufficiently secure to produce all the stipulations, phantasies and 
characteristics of her erotic desires, which lead the way into their 
infantile sources. 

"There is of course a class of patients whose transference can 
never be lifted above the erotic demand and who can therefore ac- 
quire no interest in the treatment that will lead to success. From 
such the analyst can only withdraw. 

" A true love leads to the endeavor to solve the problems of the 
neurosis because the analyst, the loved object, desires it. The 
patient wishes to complete the cure in order that she may become 
of value to the physician and also secure the reality in which the 
love may find constructive activity. The resistance, in contrast to 
such manifestation of love, makes the patient self-willed and re- 
fractory without interest in the treatment or regard for the earnest 
convictions of the physician. The erotic manifestation in which the 
resistance hides feels itself condemned under the conscientious 
behavior of the analyst, and the patient withdraws in hatred and 
burns for revenge. 

'' A necessary measure of forbearance, nevertheless, helps one to 
master the difficult situation and to utilize the eroticism to discover 
the infantile love objects with the phantasies built up about them. 

" This love is moreover a real love and not a subterfuge on the 
part of the physician. The resistance has found it ready at hand 
and exaggerated its manifestations. But this makes it none the 



TRANSFERENCE AND RESISTANCE 97 

less a genuine love. Its infantile conditioning constitutes its com- 
pulsive character, which causes it to differ from so-called normal 
love. That too arises out of the infantile but has freed itself from 
dependence upon the original model and is therefore more pliable 
and capable of modification. The genuineness of the transference 
love must find its proof in the ability of performance, its value in 
reaching the goal. 

"Its abnormal character was just as apparent before psycho- 
analysis was undertaken. The analytic situation merely shows it in 
action, while the resistances that arise force it into prominence. It 
is characterized by a disregard for reality, a thoughtlessness, an 
irresponsibility, and an overestimation of the love object, all of 
which appear in a greater degree than in ordinary love. 

" The situation as far as the physician is concerned is simply an 
inevitable part of the treatment for which he must assume the re- 
sponsibility as for any other professional confidence and trust, a 
responsibility that is only increased by the ready willingness of the 
patient. Technical as well as ethical motives determine his re- 
sponsibility and strengthen his appreciation of the therapeutic value 
of this situation. The love is to be freed from its infantile fixa- 
tions, not in order to be expended in the course of the treatment but 
to be preserved for the demands of real life for which the treatment 
is preparing the patient. 

" All this is by no means easy of accomplishment. It cannot be 
denied that sexual love is one of the chief constituents of life and 
the successful combination of psychical and physical satisfaction a 
culminating point. Moreover, the higher love impulses acknowl- 
edged and manifested by a refined woman naturally attract and tempt 
the physician. But he may never forget that he is helping the 
patient over a critical period to a renunciation of the pleasure prin- 
ciple in favor of a higher goal of attainment, one psychologically 
as well as socially irreproachable. The transference is the instru- 
ment that leads her through the understanding of her early psychical 
history to that increase of psychic freedom which shall express 
itself in conscious productive activity." 

The psychoanalyst deals with conditions that are not then with- 
out dangers. So also does the chemist handle explosive forces. I 
have seen surgeons cut into the brain tissue as if it were a piece of 
cheese. Such forces demand the utmost caution and conscientious- 
ness. But psychoanalysis accomplishes a work that cannot be per- 
formed by mean of the paltry and not harmless means which it 



..J 



98 THE TECHNIQUE OF PSYCHOANALYSIS 

displaces such as so-called "rest in bed," diet, etc. It dares to 
handle the most dangerous psychic impulses in order to master them 
for the healing of those who are sick. 

As Silberer in his masterly work on Mysticism* says : 

" Where do the Scotch masters dwell ? " 

" Near the sun ! " 

Why?" 

" Because they can stand it." 

Transference and Resistance Symbols 

A great deal might be said about signs of positive transference, 
but the analyst must always bear in mind the ambivalency of the 
unconscious as well as its egoism. A number of little indices may 
be recorded here. They are only suggestions. 

There are literally thousands of apparently trivial things which 
show the internal workings of the patient's unconscious. Patients 
often come early. It usually indicates the positive side of the trans- 
ference, just as persistent late coming points to the reverse. Some- 
times the early coming is only a sign of extreme curiosity. It is fre- 
quent in the "little bird" type already discussed. Such patients 
often utilize the time spent in waiting to gain little impressions of 
the family life, assuming one's office to be in one's own home. These 
they will utilize as resistance symbols in the further analysis. In the 
office the patients will often move their chair closer to the analyst's 
desk. They frequently will tap with their foot, an object in contact 
with the chair or person of the analyst. They will pick up objects 
which he is apt to use, play with the blotters, or toy with the office 
scissors or paper cutter. These small signs must not be unobserved, 
nor must too much weight be given to them. 

Patients will constantly leave things after the hour, sometimes 
to come back immediately or as a sign of positive transference. 
Handkerchiefs, gloves, purse, books, papers, overcoat, cane, um- 
brella, glasses, etc. The type of object left is at times of special 
moment. 

It is worth while observing the dress of the patients, particu- 
larly of the woman. It is at times plainly indicative of positive 
transference and may be the first indication of too strong a trans- 
ference, which can be controlled, with the aid of the dreams, and 
hence the more difficult phases of the situation outlined on page 93 

4 Silberer, " Problems of Mysticism," translated by Smith Ely Jelliffe, 
Moffat, Yard & Co., 1917. 



TRANSFERENCE AND RESISTANCE 99 

avoided. It can also very easily point to negative transference and 
to resistances. 

After working with some patients one may get very useful clues 
from the facial musculature activities. It is a well-known general- 
ization and probably a very valid one that, in the unconscious, left 
and right play a very large role. I have made careful notes of the 
emotional expression of the face as well as other bodily movements, 
such as rocking in the chair, drumming on the table or the arm of 
the chair, the movements of the hand to the face, the presence of 
scratching, of crossing the legs, folding the arms, crossing the fingers, 
etc. After continued observation one registers a group of habitual 
actions which soon become very readily interpreted. The facial inner- 
vation however is the richest field for observation of signs of trans- 
ference and resistance. 

With more than one patient it has soon become apparent that 
the drawing up of the right eyebrow, the pulling of the face around 
to the right, the looking to the right, etc., were domination impulses 
from the unconscious and were "complex indicators" intending to 
convey the idea of conflict and resistance. Similarly other move- 
ments indicate positive transference situations and acquiescence with 
the general trend of the analysis. It is highly desirable to watch the 
facial musculature particularly when one is dealing with the most 
difficult of cases, the paranoid forms of schizophrenia, and the cyclo- 
thymic excitements and depressions. In many males the latent homo- 
sexual conflicts are often exquisitely registered by the facial muscula- 
ture. Only in late stages of analysis, as a rule, can these deeply 
rooted and very unconscious " complex indicators " be used. I am 
not now speaking of the large group of facial tics, compulsive in 
type, which constitute difficult problems of themselves. 

It is well known by those who have studied Darwin's and 
Hughes' extensive observations on emotional expression how in- 
trinsic these observations may be, and the practical man of the street 
is unconsciously in touch with his fellow man through these means, 
infinitely more than he imagines. This close scrutiny of these fac- 
tors is largely what goes by the term intuition, particularly in women, 
who unconsciously are always more on guard than men by reason 
of her chiefly subordinate role in the present social scheme of things. 
Long letters, frequent telephone calls, getting other patients, much 
discussion of their physician, these again are transference phenomena. 

This introduces us to a topic already spoken of but which needs 
reemphasis. The advice not to talk about the analysis to other 



100 THE TECHNIQUE OF PSYCHOANALYSIS 

people is quite essential. I repeat it here since it must often be 
reiterated to the patient. This is largely because the patient un- 
consciously will unload a great deal upon the confidant or person 
talked to, and comes to the analytic hour without a suggestion. On 
being asked, as it is usually the case that they are, What is upper- 
most in your mind to discuss? or What do you wish to talk about? 
or Are there any points to take up from the last analysis ? such 
patients, who have been discussing analysis with their husbands or 
wives or friends, will answer, Nothing! In some subtle and un- 
conscious way the important topics which will aid them to a valu- 
able vision of the development of their conduct values have gone off 
in these side discussions. Hence the admonition to keep the dis- 
cussion for the hour. This is particularly true in the early hours 
of the analysis. One should warn one's patients of course not to 
make any mystery of the situation. The rule is not one of the 
Medes and Persians and it can be broken, but on the whole it works 
better to have one's ammunition reserved for the psychoanalytic 
hour. 

Certain resistance symbols also are classical. Coming late, as 
mentioned, is one. Delaying appointments and putting them off is 
another. The resistance is frequently converted into physical dis- 
abilities which make it difficult or impossible to keep the appoint- 
ment. Dreams or other material written out are forgotten and left 
at home or are unaccountably mislaid or lost. Criticism and doubt 
of the physician appear not only in the dreams but are produced 
consciously in order to substitute an apparent distrust of his personal 
character, his sincerity of purpose or perhaps his financial upright- 
ness in regard to the treatment for the unconscious unwillingness to 
acknowledge the sincerity and therefore the authority of psycho- 
analytic interpretation and the demands of its aim. Sometimes 
the finesse of the unconscious is extremely shrewd in manufacturing 
a host of little petty hindrances which successfully conceal the 
patient's resistances. 

Another interesting type of resistance is the sudden cure. Stekel 
has called particular attention to this.^ Another closely related type 
manifests a sincere doubt whether such fundamental treatment was 
best, whether it would not have been better after all to have remained 
at the level of compromise where the patient had had fair success 
before the analysis. Especially is this active with the typically 

5 Die Verschiedene Formen des Widerstandes in der Psychoanalyse, 
Centralblatt, IV, 1914, p. 610. 



TRANSFERENCE AND RESISTANCE 1 01 

doubting compulsive neurotic, particularly if his early religious train- 
ing or his metaphysical convictions are interfered with. 

Excessive or voluble speech in the hour whereby the more im- 
portant things may be hidden or swallowed up is a frequent form of 
resistance. This is particularly noteworthy with certain paranoid 
individuals who wish to go into a host of intricate theoretical dis- 
cussions concerning the psychoanalytic doctrines. A profusion 
of dream material, either in the number or elaborate content of 
dreams, offers this same manner of resistance. The patient then 
would dissipate the analyst's attention upon all the dream material 
rather than have him center it intensively upon one dream or one 
point. These are only other illustrations of the school-day trick of 
getting the teacher to talk about something else and thus avoid 
questioning. It is often very ingeniously accomplished in psycho- 
analysis, and my experience has emphasized the fact that I have 
fallen down, and other analysts have also, on this very point. The 
analyst can too readily forget his quarry and go off on an exhibi- 
tionistic flight of his own. Especially when he attempts to tell of his 
analytic successes is this liable to happen. 

Some patients are full of the small details of the day. They 
elaborate them by the hour. These are resistance symbols usually. 
Others are those of elaboration of scientific or artistic theories. 
Interesting enough in themselves, and often recounted or dwelt upon 
for professed analytic purposes, they nevertheless not infrequently 
hide unconscious material. 

A not infrequent unconscious ruse on the part of the patient and 
one to which the beginning analyst is particularly prone to fall, and 
sometimes it is not a fall, is the attitude frequently urged that 
because of the uniqueness or the extreme rarity or complexity of 
the patient's individual situation the analyst cannot possibly compre- 
hend. He is inexperienced in this or that particular. He has not 
the same temptations or the same surroundings. The patient un- 
consciously plays for intimate knowledge of the analyst's own diffi- 
culties. This is very clearly brought out by many patients, par- 
ticularly the "little bird" type. This inquisitiveness and curiosity 
leads them to create family situations. They may remark how the 
maid at the door has been rather brusque with them that morning; 
or they notice that there is a little careless dusting in the waiting 
room, or they inquire concerning the arranging of the books on the 
reading table, complimenting, by inference, the wife or some other 
member of the household. All this is frequently an invitation of 

8 



102 THE TECHNIQUE OF PSYCHOANALYSIS 

one kind or another to get into a more intimate state of rapport. It 
is good technique to keep very quiet about one's self, to allow as 
little as possible of one's own surroundings to enter into any ana- 
lytical situation. Occasionally the analyst is tempted to show, from 
his own dreams or situation, that he himself has had these conflicts, 
has made mistakes, has defects, and by entering into greater intimacy 
overcome some of the patient's resistances. Mutual trustworthiness 
is looked for, and Freud has well said:^ "Where one seeks con- 
fidences one must be willing to show them." In some cases this may 
be desirable, but in my own experience it has nearly always proved 
costly. I have frequently to labor hard to regain ground lost. In 
general it is dangerous and one really gains nothing, since much more 
essential resistances develop to appear later and these tend to hold 
the whole procedure in abeyance. I think sooner or later I have 
regretted every personal confidence given. It is particularly in the 
unloosing of the transference that this technical error shows up to 
the greatest disadvantage. Freud calls attention to this in several 
of his papers, and points out how for some patients the analysis of 
the analyst becomes more interesting than their own. I have met 
with this in several cases. One hystero-paranoid type of patient was 
a marvel of ingenuity in her endeavor to get all of the small details 
of my home life and wherever she caught me napping I later suffered 
for my — even the slightest — indiscretion. 

The ideal situation is to stick to the unconscious of the patients 
and simply reflect back to them what their unconscious shows. They 
must get to the point of faith in their own productions and be abk 
to read themselves in the mirror that the analyst constantly keeps 
before them, as inscrutably as possible, and yet human. 

In institutions where analytic therapy is used " it is not a serious 
fault, possibly, to admit some suggestive therapy admixture, but there 
should be no doubt in the mind of the physician that he is not practis- 
ing psychoanalysis when he utilizes suggestive therapy."'' 

Very frequently the patients will seek instruction from the ana- 
lyst. They will bring their troubles and their cares, their disappoint- 
ments, discontents, problems, dilemmas, jealousies and misunder- 
standings. They will wish to talk of them and expect advice or 
suggestion as to their solution. In the handling of this particular 
type of situation psychoanalysis occupies an entirely different role 

6 Ratschlage fiir den Arzt b. d. psychoanalytische Behandlung, Central- 
blatt, II, p. 487. 
■^ Freud, 1. c. 



TRANSFERENCE AND RESISTANCE IO3 

than most other types of psychotherapy. I can refer the analyst to 
a thorough study of this handhng of the actual conflicts of the 
patient in a paper by Jones which is important.^ The most successful 
mode of approach to this problem is to direct the patients' attention 
exclusively to the causes of their conflicts, not to advise how to 
handle them but to get the patients to comprehend how they arise. 
If the analyst gets into the exclusive role of the teacher and the 
adviser, his psychoanalysis is practically at an end and the patient 
will not have to have his resistances analyzed and will go on with 
his neurosis. The advantages of the psychoanalytic mode of ap- 
proach are evident, as Jones points out. In the first place one is 
unable to point out the solution of a conflict until it has been ana- 
lyzed. Either the patient already knows what he has to do, but 
is not in possession of the reasons why he is unable to do it, or he 
does not know at all what is the best solution of the problem. Pos- 
sibly the physician can guess a correct solution of the conflict and give 
good advice, but what about the patient when a slight variant turns 
up? The position of a student who uses a pony with his translations 
is thus reproduced. He is unable to dig the thing out for himself 
and is helpless in a test. So it is with the patient who is advised 
what to do, and this constant seeking for advice is one of the most 
insistent cries that goes up day by day with neurotic patients. What 
am I to do? they ask. Give me something practical, they say, and 
the reply "Know thyself" is hard for the analyst to stick to. 

While upon the subject of resistances, for the sake of complete- 
ness I would call the student's attention to a paper by Reik on this 
subject.^ 

Whoever has followed attentively the publication of the first 
analyses of hysteria,^^ from which psychoanalysis dates its existence, 
cannot overlook the significance of defense symptoms in the course 
of treatment. The theory of the resistance (and of the transfer- 
ence) which was developed from the observation of those signs of 
defense, showed itself even more clearly as one of the fundamentally 

8 Die St'ellungsnahme des psychoanalytisches Arztes zu den aktuellen 
Konflikten, Zeitschrift, II, p. 6, 1914. 

9 Einige Bemerkungen zur Lehre vom Widerstande, Zeitschrift, III, i, p. 
12, 1915. 

10 Freud's Hysteria Analyses. A complete hysteria analysis is lacking in 
the English language. The editors of the Nervous and Mental Disease 
Monograph Series purpose to remedy this defect by publishing the full 
analyses of Freud's most important cases, for the translation of which they 
are indebted to Dr. A. A. Brill. 



104 '^^^ TECHNIQUE OF PSYCHOANALYSIS 

recognized principles of psychoanalysis, and Freud first briefly 
stated^^ that this motive over and above the special results of the 
analytic work, has for him " remained decisive for his conviction 
concerning the etiology of the neuroses." 

This factor of the resistance has received relatively little atten- 
tion in psychoanalytic literature thus far, notwithstanding its great 
significance theoretically and practically. The following up of the 
role of the resistance during the course of treatment in addition to 
the symptom and dream analysis escapes a separate presentation, as 
every one will recognize who knows how many difficulties offer them- 
selves in the description of a single completed analysis. The resist- 
ance drags itself through the analysis like a red strand as difficult to 
be separated from the whole structure as such a strand from' a trans- 
atlantic cable. 

The answer to the question how the resistance manifests itself 
may be read in all those obstacles which oppose themselves to the 
restoration of the patient's health and efficiency. This statement 
needs some qualification. For among the hindrances against reach- 
ing the goal mentioned there are also external ones, such as social 
and pecuniary circumstances, certain family relationships, definite 
conditions of external life. There is greater danger of overvaluing 
than undervaluing the significance of such circumstances alterable 
as they are only with difficulty, though they must not be overlooked. 
yy The physician, to whom the patient complains of these circum- 

stances, must for their valuation keep the following in view: i. The 
fact that much distress, which at first sight seems undeserved, was 
brought about by the patient's unconscious wish, or at least its break- 
ing forth was not prevented, although that was possible objectively 
considered. It must not be forgotten that the patient who finds him- 
self in such a position would unconsciously divert the physician's 
attention from the true cause of the illness and on that account 
represents as its fundamental cause what is in fact the result of his 
neurosis. The patient, who goes on living under these conditions, 
will often maintain the neurosis for the sake of a secondary advan- 
tage obtained from the illness, for an unconsciously voluntarily in- 
voked possibility. Reik gives an example. One finds no oppor- 
tunity to earn money, although he seeks it with apparent energy and 
suffers much from an oppressive poverty. It must be accepted in this 
case — not always of course, but frequently — that the individual con- 

11 Zur Geschichte der psychoanalytischen Bewegung, Jahrbuch der Psy- 
choanalyse, 1914, p. 5 f. Translation published as Monograph Series No. 25. 



TRANSFERENCE AND RESISTANCE IO5 

cerned unconsciously overlooks many opportunities, indeed that he 
himself even with unconscious purpose spoils many opportunities. If 
one looks for the motive of such amazing behavior, one comes fre- 
quently upon the tendency towards self-chastisement, which flourishes 
upon an unconscious sense of guilt. It may be said that the over- 
valuation of such external conditions parallels the pre-psychoanalytic 
over-valuation of hereditary causes. 

2. The psychoanalyst will cherish the expectation that the ac- 
complishment of the analysis will clear away a large portion of these 
obstacles. The physician will without directly interfering by counsel 
or act in the circumstances under consideration patiently watch the 
time draw near when the patient, freed from his inner hindrances, 
himself takes the initiative and with insight and energy once more at 
his command brings about those changes which appear to him 
desirable. 

3. The physician, to be sure, stands powerless before a portion of 
the external difficulties, objectively considered, yet he may console 
himself with the knowledge that their removal lies only in the sphere 
of influence of a higher instance, all-powerful fate. 

Manifestations of resistance are to be found in all those obstacles 
which the patient opposes to his recovery. Attention has been di- 
rected to the most prominent difficulties of this sort, lack of asso- 
ciations, forgetting, and the like. The opposites, also, love of gossip 
and loquacity, as resistance symptoms, belong again to the question 
of the selection and censorship of associations. The physician, who 
at the beginning of the treatment bids the patient as the first and 
special condition of the psychoanalytic relationship, to tell every- 
thing and to allow no censor control of his associations, knows in 
advance that this condition will not be fulfilled by the patient. For 
rather the degree of departure from this ideal relationship becomes for 
the physician a sign of the greatness of the resistance. Over against 
the failure of associations stands oftentimes an excess of freely 
ofifered outspoken thought which would, like the first, lead the physi- 
cian astray. The psychoanalyst must not allow himself to be taken 
thus unawares. He will suspect that such a wealth of association 
has the same purpose, to hide from him and keep from him just 
that which perhaps is necessary to the releasing of a symptom. He 
understands this just as he did the want of associations, which he 
knew served a purpose, representing the rising up of the resistance 
against painful confessions. The structure of the thought material 
in this case may be compared perhaps to a wide-meshed net, through 



I06 THE TECHNIQUE OF PSYCHOANALYSIS 

whose interstices the most valuable slips away. It many cases it can 
be ascertained that the patient had the day before or the same day 
made note of a great number of incidents in order to relate them to 
the physician. The latter will not overlook the fact, however, that 
such gifts spread out upon a tray seldom bring that which one had 
desired. Generosity on the one side merely hides niggardliness on 
the other. Where such eloquence has already appeared as a resist- 
ance symptom an unconscious motivation may with great probability 
be suspected behind such a readiness, that it to say, the wish to defy 
the physician to drag on the analysis. Indeed it is plain that there 
lies often in such a state of things an unconscious ridicule of the 
physician, the infantile character of which becomes clearer, if one 
thinks of the grotesque tales of children which they relate to their 
parents in regard to the ostensible origin of children and in which the 
ridicule of the stork fable and the persons concerned in it manifests 
itself. The unconscious homosexual is particularly prone to this 
feature of the ridicule of the physician through his gossip and free 
discussion of small scandals. 

Form, intensity, as well as the point of time when the resistance 
enters in the course of treatment Reik points out, vary so much that 
a classification of patients on this basis suggests itself. It may be 
observed, for example, that a bitter and persistent resistance appears 
later with just those patients with whom the transference was estab- 
lished quickly and easily and who apparently manifested no symp- 
toms of resistance, while most cases where intense resistances toward 
the physician allow at first sight a limited outlook permit a favorable 
prognosis. One should begin to mistrust when " all goes smoothly " 
in psychoanalysis, when no resistances of any sort manifest them- 
selves. One must be suspicious likewise of all those modifications 
of analysis which may boast of having diminished the resistances or 
set them aside. Psychoanalysis may be compared to the work of a 
machine, for the efficiency of which the presence of friction is an 
indispensable condition. 

Reik calls attention to more or less direct manifestations of re- 
sistance such as outbreaks of anger against the physician or a third 
person. The passage from one form of resistance over into another 
may be observed daily in the analysis. It happens indeed that the 
form of the resistance changes with the taking over of a patient into 
the treatment of another physician, a practice principally to be 
avoided. Thus a patient displayed his resistance against the physi- 
cian who was treating him in continually complaining that the doctor 



TRANSFERENCE AND RESISTANCE IO7 

and his method did not interest him, that what he said was a matter 
of indifference and wearisome. He, the patient, stood toward him 
with a feeling of distant respect which frequently passed over 
into a feeing of superiority. After a visit on one occasion to the 
consultation room of another psychoanalyst the resistance prepared 
for itself an elementary path in which the patient characterized this 
second physician immediately on leaving his house, as a " disgusting 
Jew " and complained of his so-called hardness and heartlessness. 

Concealed forms of resistance phenomena are however the more 
frequent. Thus Abraham reports a patient whose resistances had 
created a very interesting esthetic mask. The patient evinced fre- 
quently during the hours of analysis a strong displeasure in the 
objects in the consultation room. He found this piece of furniture 
out of place, that arrangement in poor taste and so on. Naturally 
the form and content of this, as of all resistances, is psychically de- 
termined and over-determined and an indicator to the analyst. The 
whole sum of the neurotic resistance is learned first of course through 
dream and symptom analysis ; in these creations frequently there 
hides a flood of most malicious wishes and insults directed against 
the physician. This illustration of Abraham I have had repeated over 
and over again with my books, my rugs, my ornaments, my clothing, 
etc. One patient hides a frightful snobbery clothing complex behind 
a criticism of my clothes. Other infantile superiority motives are 
the rule in resistance situations. 

Just as Abraham's patient found an opportunity for directing his 
resistance toward the physician in an exasperated criticism of the 
arrangement of his house, and others in the manner just mentioned, 
so also it happens that the resistances find their objects in the rela- 
tives and acquaintances of the physician. The parallel to the relation 
of primitive people thrusts itself forward here, as Reik emphasizes. 
The savage who wishes to injure some one possesses himself perhaps 
of a bit of property of the person under consideration and believes 
that through the medium of this object he will also have power over 
its owner (contagious magic) .^^ If the savage believes himself in- 
jured or wronged the law of tribal revenge comes into play, to which 
not only the person who committed the deed but his relatives and 
friends as well must submit. The criticism of the physician's furni- 
ture and the ill-will toward his relatives is analogous to this state 
of things. Reik speaks of a patient where the dissatisfaction of the 
patient with his physician was manifested in this fashion, that he 

^2 See Zenia, X., Psychoanalytic Review, Vol. 11. 



I08 THE TECHNIQUE OF PSYCHOANALYSIS 

began the hour of analysis with railing against the incivility and 
stupidity of the maid servant. One difficult patient of mine always 
revealed his resistances by ringing the front door bell two and even 
three times in quick succession while waiting to be let in. His 
"Jehovah complex" admitted of no delay in letting so important a 
person in the house. I was never quite able to have him see his 
hatred — resistance — through this apparently trivial incident. Yet it 
was apparent in every detail of a busy and, commercially speaking, 
successful life. He had a very bankrupt soul, however. 

Reik also emphasizes the analogous variations of the means of 
transference, such as great interest on the part of the patient in the 
members of the physician's family, inclination toward them and 
great respect, behind which often, especially with female patients, 
lurk unconscious death wishes. Reference must repeatedly be made 
to the fact that the patient creates for himself in his relations with 
the physician a return of infantile situations. The infantile CEdipus 
situation is thus completely reestablished — just as the physician 
appears as the revival of the father, so his wife is often the mother — 
when a strong love toward the wife or the daughter, whom the patient 
has perhaps never seen, joins itself to the neurotic's resistance against 
the physician. Moreover strong feelings of jealousy against the 
physician's sons may be looked upon as a return of childish impulses, 
brother jealousy. In one of Reik's cases the patient complained 
with strong affect of the behavior of another patient quite unknown 
to him, whom he had met in the physician's waiting room. This 
analysis revealed that behind these complaints were hidden re- 
proaches against the physician, who seemed to give preference to 
the other patient as once the father had favored the brothers of the 
later neurotic patient. It often becomes clear in the analysis with 
what the resistance, which announces itself in the lack of associa- 
tions or in the repression of their disclosure, concerns itself. There 
are at work besides the shrinking from the confession of unpleasant 
things and those which would wound the ego of the patient, definite 
hostile impulses against the physician. In certain cases the increas- 
ing silence in the analysis signifies directly the unconscious self- 
punishment for evil wishes against the physician. A very intellectual 
woman, suffering from a compulsive neurosis, once offered the in- 
formation spontaneously that her becoming speechless really repre- 
sented how she died. 

In a preceding page of this book I spoke of the free patient in 
psychoanalysis. Reik also discusses it in the paper just referred to. 



TRANSFERENCE AND RESISTANCE IO9 

He regards it as deserving a special chapter. The refusal on prin- 
ciple of the free treatment which Freud recommends^^ rests also on 
this, that the free treatment under certain conditions produces a 
special heightening of the resistances. Gratitude prevents the patient 
from manifesting his resistances in the same form and with the same 
intensity as the other patients. The location of the resistance must 
then be sought out with difficulty by the physician and discovered. 
He meets then among other things the haughtiness of the young man 
who will allow so very little to be given him by the physician, as once 
by his father, and also the distrust toward the physician, which re- 
veals itself in the anxiety that he will not be treated by him with the 
same care as other patients blessed with this world's goods. 

Reik gives examples which may be duplicated in any psycho- 
analytic treatment. The physician is prevented some time from keep- 
ing the hour for analysis and writes to the patient to break the 
appointment. The next interview brings surprisingly great resist- 
ances not justified by the things which are discussed. The patient has 
understood the breaking of the engagement as a sign of unconscious 
depreciation and brings it into connection with the free treatment. 
His narcissism takes the occurrence as a humiliation and to this 
actual disturbance is to be ascribed the increase of resistances. Natu- 
rally the feeling of shamed love (unconscious homosexual) con- 
tributes essentially to this effect. 

Reik speaks of one form of resistance phenomena. This is the 
" proofs " by which the patient will convince himself of the reality 
of psychoanalysis. Many patients after a significant explanation on 
the part of the physician immediately make proof of an example 
as it happened to that patient in Freud's " The Interpretation of 
Dreams " who reacted to the information given as to the theory of 
the general wish- fulfilling tendency with a negative wish dream. As 
an example we may suppose that the patient has just discovered a bit 
of the motivation of his chief S3^mptom, psychic impotence. He 
hastens now to find the opportunity for sexual intercourse and suf- 
fers failure at coitus. He has through this merely given expression 
to his unconscious resistance against that explanation, to which he 
perhaps some hours before had heartily agreed and which he con- 
sciously received almost as his salvation. On the other hand the 
more favorable case may be adduced. Coitus succeeds and the full 
capacity for satisfaction is this time again established. There must 

^3 Weitere Ratschlage zur Technik der Psychoanalyse, Internationale 
Zeitschrift fiir arztliche Psychoanalyse, 1913, Heft i, S. 8 f. 



no THE TECHNIQUE OF PSYCHOANALYSIS 

then be considered a transference result, which the first disturbance 
of transference again destroys. 

E. Jones^* has said all that is essential concerning the mistakes 
which the psychoanalyst would commit if he interfered in the actual 
conflicts of the patient through advice ; for example : It might be taken 
for granted that the advice of the physician would be suited to solve an 
actual conflict, yet the wished- for result might not appear. Then the 
patient's resistances will again appear in the unconscious ; he will 
perhaps meet with some misfortune in the carrying out of the advice, 
he will keep strictly to the letter of the advice and miss its intention 
or unconsciously perhaps he will prefer some modification, which 
complies with his secret wishes. The failure in outcome will then be 
utilized for the increase of the resistances while the blame will all be 
laid upon the physician. Often, moreover, a tertiary advantage 
enters in for the illness just through such giving of advice, for the 
transference becomes permanent, the patient will no more dispense 
with dependence upon the physician and remains sick in order to 
justify this relationship. 

Then the phenomenon, well-known to psychoanalysis, of the 
"haughty obedience" comes to light. The patient slavishly follows 
the instruction of the physician but expects him to uphold, it may be, 
the manner of life created by the advice. Reik speaks of certain 
patients who behave in their "passive resistance" just as do the 
German railway oflicials. There exists in the regulation of the 
German as well as of other railways a number of instructions and 
commands, the invariable carrying out of which into practice would 
paralyze all traflic. There is therefore a tacit agreement between 
higher officials and subordinates to overlook these orders at times 
and to keep traffic going according to other more practical rules. If 
now the railway officials and workmen have cause for dissatisfaction 
with their wages, hours of duty, etc., they adopt a "passive resist- 
ance," that is, they maintain a strict adherence to the instructions of 
the rules in their work and bring about, through this grotesquely un- 
just kind of officially demanded strike, serious disturbances in the 
regular traffic, even not infrequently a complete standstill. 

The last — often very difficult to overcome — resistance in the 
treatment is the final doing away with the transference. The patient 
strives by all means of defiance, yes, of hatred, against turning his 
love away from the physician and placing it upon others. 

I must not neglect this opportunity to emphasize an important 

14 L. c. 



TRANSFERENCE AND RESISTANCE III 

notive to which Reik also refers. An actual obstacle to the setting 
up of the transference may present itself according to the manner 
in which the psychoanalyst takes note of the neurotic's complaints. 

In Reik's own words : " Suppose that a nervously sick woman 
comes to a neurologist and complains that she is pursued by a com- 
pulsive thought, that she must poison the husband she tenderly loves. 
The conflict which this temptation toward feelings directed against 
her husband arouses, causes her constant suffering. What atti- 
tude would most neurologists take to such a case, a by no means 
rare one? They will listen to her tale with grave shakings of the 
head, and then attempt to talk the poor woman — supposedly she has 
shown herself mentally sound otherwise — out of her compulsive idea, 
while they would perhaps say : " But that is nonsense. Dismiss it 
from your mind. Try with all your might not to think of these 
things. Find distractions, go to the theater, to concerts, travel, and 
the like."i5 

It needs only to be mentioned, through a reference to the impossi- 
bility of dismissing it from the mind, how such a therapy ridicules 
itself, and does not understand how. The psychoanalyst who has 
listened to the patient's complaint will express himself something 
like this : " Now, that is very interesting. Tell me, please, when this 
idea first appeared to you, in what connection, and so on." In a word, 
he will not shove the compulsive idea to one side as unpleasant and 
senseless, but take it for granted, on the contrary, that a definite 
meaning belongs to it in the patient's mental life, that it has some 
connection with her experiences, wishes and conflicts and that the 
problem will be to ascertain the psychic motivation and the latent 
meaning of the idea. 

The comparison of the psychotherapeutic effectiveness of the two 
methods is not now under discussion, hence for the moment the stress 
will only be laid upon the effect upon the patient herself of the taking 
up of what she has imparted. While the telling of her idea here- 
tofore has always met with a depreciation of it, at the very least with 
an ironic or slight smile on the part of the physician, on the part of 
the psychoanalyst she finds understanding as he accepts the idea 
quite earnestly, believes in its meaning and its significance and occu- 
pies himself with its origin and development. Here, however, with 

15 Other methods will direct their measures to this end, that the idea be 
recognized as completely foolish. It may be desired to set it aside by hypno- 
tism and Dubois would not leave out the ethical stimulus and strengthening 
of self-confidence. 



112 THE TECHNIQUE OF PSYCHOANALYSIS 

this serious acceptance, the first actual possibiHty of the transference 
arises. The patient is wounded in her narcissism through the slight- 
ing or depreciation of her idea, yet the attention which the psycho- 
analyst bestows upon all her manifestations and symptoms, even the 
most absurd and bizarre, works beneficially although it flatters her 
self love. It must not be forgotten that patients can consciously 
observe and curse their ideas and symptoms as foreign to them or 
comprehend them unconsciously as products of their own personali- 
ties and care for them perhaps with the love with which a mother 
devotes herself to a crippled child. The neglect or the depreciation 
of a symptom or anything brought by the patient, which perhaps 
announces itself in the relinquishing of the usual amount of atten- 
tion, would therefore mean a two-fold technical error on the part of 
the physician. The result would be not only a loss of psychological 
knowledge but also an increase of resistance due to the wounding of 
the patient's narcissism. This neurotic narcissism shows itself in a 
certain valuation of the patient's own illness, by which he grants to 
his own illness an exalted position, will not see the typical character 
of his neurosis in connection with other cases, but considers his as 
a distinctive special case which demands increased attention. 

A factor of the greatest importance and one that is well known to 
all physicians who practice analysis concerns itself with the analyst's 
own negative transferences. I have made special note of these as 
illustrated in the persons assisting me in psychoarialytic work. It is 
remarkable how in the course of an analysis one hears of the '' diffi- 
cult " patient. The use of such a concept usually means an opposing 
force on the part of the analyst. It is only all too deeply grounded 
in the human soul as Reik well says, that a feeling of impatience and 
anger takes possession of the physician especially at that point when 
the severe resistances rouse themselves against him. The danger is 
particularly at hand when the treatment through the intensive re- 
sistance of the patient has reached a *' dead lock," that the feeling 
of dissatisfaction over the temporary standstill and over the obstinacy 
of the patient strengthens itself even to a negative resistance, which 
manifests itself in a withdrawal of interest in the patient or even 
produces a change in the manner of treatment. The consequences 
of the existence of such a negative resistance upon the progress of 
the analysis would naturally be most unfavorable. 

Freud tells us through what psychic mechanisms resistances arise. 
It might be pointed out on what basis they rear themselves and to 
what instinctive impulses they owe their strength. Reik speaks of 



TRANSFERENCE AND RESISTANCE II3 

three chief components that work together to constitute the resistance ; 
narcissistic, hostile and closely bound with them, homosexual cur- 
rents and anal erotic tendencies. 

I. The beginning analyst will soon commence to appreciate the 
significance of the narcissistic attitude and its disturbances for the 
question of the resistance. A partial derivation of the resistance 
from narcissism becomes clearer when the inner relation between re- 
pression and resistance is understood. Primary narcissism con- 
tributes to the ideal ego structure. This becomes the condition of the 
repression on the part of the ego.^*^ Through analysis, however, the 
comparison between the actual and the ideal, always present in the 
unconscious, is transplanted to the soil of the conscious. The con- 
flict between the tendencies directed toward and against the ego 
is again, under changed circumstances, taken up, whereas before 
through the compromise formation of the neurosis it had come to a 
truce, which was however repeatedly disturbed. The physician be- 
comes to the patient the unconscious incarnation of that censor which 
is in conscious phraseology called " conscience." This deduction can 
also be supported genetically, since conscience is primarily based 
on parental criticism and guidance and the physician comes to be for 
the patient the revival of the authority — father or what not. The 
patient naturally strives against the constant comparison between the 
actual and the real, to the conscious carrying out of which the 
analysis compels him, while it shows him how his conscious inten- 
tions and deeds measured to the ego ideal are continually disturbed 
through the unconscious events belonging to his actual ego. 

Those numerous cases of neurosis in which the " castration com- 
plex" appears in the pathogenesis, hold a special position. The 
resistance of the patient assumes a character as if the physician repre- 
sented the father in his part as sexual meddler and intimidator. This 
fear may find support in the unconscious memory of the father's 
threat of castration for infantile over-interest in the child's ow^ 
member. If one follows further the castration anxiety directed 
toward the physician, forbidden (for example, incestuous) wishes 
come regularly to light. The child has unconsciously incorporated 
the characteristics of the father in his ideal ego in so far as the com- 
parison of the child oppressed by his dark instinctive forces with the 
father offers an obstacle to the formation of his ego ideal. So the 
physician as the father representative (social necessity, etc.) comes 

16 Cf. Freud, Zur Einf iihrung des Narzismus, Jahrbuch der Psycho- 
analyse, 1914, p. 17 f. 



114 "^HE TECHNIQUE OF PSYCHOANALYSIS 

to be the external ego ideal. A great part of the transference situa- 
tion must find its explanation here. The resistance, considered from 
this point of view, may be described as the striving against the dis- 
charge of homosexual libido values. 

2. Hostile currents against the physician in the form of resistance 
are conditioned through the revival of those feelings once belonging 
to the father. The typical attitude of the individual toward the 
father however is ambivalent, so the hostile tendency has continually 
to strive with the tender one, the unconscious continuance of which 
produces homosexual feelings. The intensity of the hostile feelings 
directed against the physician is reactively strengthened -through the 
defense on the side of his own homosexual onset of libido. The 
resistance presupposes also properly a portion of the result of that 
psychic mechanism, which Freud's analysis uncovered especially in 
the paranoic forms of disease,^^ the reaction to the endopsychic per- 
ception of one's own homosexual tendencies. Resistances here there- 
fore become defense measures which arise from the fear of tempta- 
tion. Their purpose is to assure the male patient against his homo- 
sexual, the female patient against her own heterosexual impulses. 

The fact that the resistance grows in more than one point directly 
out of the transference and its psychic resulting phenomena has 
been stressed again and again. Reik also speaks of it. Thus, he says, 
the patient seeks, after an extensive transference has been set up, to 
win the unconsciously loved physician to himself, he will impress 
him, show him his best side. The analysis hinders him in this, be- 
cause it compels him to confess just those things through which, 
according to his opinion, he will fall in the estimation of the physi- 
cian. Resistances, as they manifest themselves perhaps in suppress- 
ing of incidents, may often be interpreted definitely as signs of 
homosexual and narcissistic tendencies of the libido. The relation- 
ship of this to consciousness of guilt can be easily established, thanks 
to Freud's explanations :^^ The want of satisfaction through the non- 
fulfilment of the narcissistic ego ideal frees homosexual libido, which 
is changed into consciousness of guilt. " The consciousness of guilt 
was originally fear of the parental punishment, more correctly of the 
love desire associated with the parents ..." [Freud]. The neu- 
rotic shows in the form of resistance we have described regressively 

^■^ Cf. Freud, Psychoanalytische Bemerkungen iiber ein autobiographisch 
beschriebenen Fall von Paranoia (Dementia Paranoides), Kleine Schriften 
zur Neurosenlehre, 3 Folge, p. 251 f. 

18 Zur Einf iihrung des Narzismus, p. 24. 



TRANSFERENCE AND RESISTANCE II5 

this psychogenesis of the consciousness of guilt, since he is un- 
consciously afraid that his confessions may have as a result with the 
physician the desire for love.^^ 

3. The third feature to which Reik calls attention, and only 
touches upon, concerns residual phenomena, regressive revivals or 
reaction formations of the infantile anal erotic. Freud^^ and Jones^^ 
have vigorously drawn attention to the inner connection of anal erotic 
and hostile impulses. It seems that a certain relationship exists be- 
tween the neurotic restraining and repressing of affect and the in- 
fantile pleasure in retaining the excrement. 

Reik attempts to define the special form of this relationship and 
the finer mechanisms which bring these two processes together. It 
seems to him certain that those two characteristics, which Freud has 
noted as constantly bound with the anal erotic character,^^ avarice 
and obstinacy (as intensifications of frugality and self-will), must 
claim a place in the structure of resistance symptoms. Whoever has 
once carried through an analysis will have met during its course with 
those neurotic manifestations of obstinacy and had opportunity to 
observe the stinginess of the psychoneurotic in the form of a resist- 
ance to giving out the unconscious material. 

The patient revives regressively in his resistance his strife against 
every person of his childhood who compelled him to renunciation of 
pleasure in infantile sexual activities and phantasies. Thus the 
analysis becomes a condensed recapitulation of the living through of 
those important inner conflicts which the patient would escape 
through flight into his illness. 

It has frequently been noted that the neurotic resistance phe- 
nomena like other neurotic symptoms are fitted for the character of 
a compromise, as Reik happily illustrates. " In the production of 
their symptoms and of the resistances directed against their removal 
it happens to those who are neurotic just as with the hero of one of 
the unjustly forgotten parodies of Nestroy. His tenderly loved one 

19 The state of affairs with a compulsive neurotic patient of Freud fur- 
nishes a beautiful example of a resistance conditioned thus. Cf. Freud, Be- 
merkungen liber ein Fall von Zwangsneurose, Kleine Schriften zur Neurosen- 
lehre, 3 Folge, p. 159. 

20 Die Disposition zur Zwangsneurose, Internationale Zeitschrift f. arztl. 
Psychoanalyse, 1913, Heft 6. 

21 Hass und Analerot'ik in der Zwangsneurose, Int. Zeitschr. f. arztl. 
Psychoanalyse, 1913, Heft 5. 

22 Charakter und Analerotik, Kleine Schriften zur Neurosenlehre, 2 Folge, 
p. 132 f. 



Il6 THE TECHNIQUE OF PSYCHOANALYSIS 

. had once sent a beautiful walking stick as a gift to the young dreamer. 
The fickle maiden became untrue to him, and the poor fellow, 
crushed by this fate, wandered through the country as a destitute 
musician. Still as an aging, embittered man he always carried his 
staff along with him. Asked once what was the reason for this he 
answered : " I carry this stick in order to keep forever in mind a 
person whom I wish never more to remember." 

I have previously spoken of Ferenczi's contribution to the sub- 
ject of transference, and inasmuch as he discusses the highly im- 
portant questions of suggestion and hypnotic rapport in this same 
paper his ideas properly belong here. 

Numerous illustrations have already been given of the means 
taken, chiefly by the unconscious of the patient, by which they may 
escape insight into the various factors at work in their conflict. The 
transference-resistance (ambivalent hate and love) falls upon the 
physician who is carrying out the analysis. It must be repeatedly em- 
phasized that these phenomena are not restricted to psychoanalysis, 
nor are they related necessarily to physicians. They are the results 
of fundamental mechanisms and thrust themselves into every situa- 
tion in life. Practically every novel or play ever written, and which 
is a true work of art, as distinguished from the run of pot-boilers, 
is a clinical expose of these factors, all the more penetrating in pro- 
portion to the genius of the artist. The works of George Eliot, 
Thackeray, Dickens, Meredith, not to mention hosts of others are 

I replete with illustrations of the various points we have been dis- 

cussing. 

I There comes to my mind now a pathetic picture of a New Eng- 

land school teacher, trivially wounded in the back, who has main- 
tained a lifelong invalidism — and a most fascinating and charming 
invalid she is — in order (unconsciously, of course) to be cared for and 
supported by an equally charming and idealistic old bachelor. This 
unconscious love relation has existed now fifty years and neither 
of the principals has a ghost of a notion of the real situation. The 
neurosis has to be maintained. Similar situations are met with in 
everyday life on every hand. 

Every one is familiar with the numerous food eccentricities of 
people, which in their more exaggerated forms we so frequently 
stigmatize as hysterical. The desire for indigestible things, or un- 
usual things, for certain preferences and aversions which may be 
related to the form or consistency or the smell of food. Many of 
these are readily and sometimes quickly traced to their infantile be- 



TRANSFERENCE AND RESISTANCE II7 

ginnings and usually run down to displacements of the repressed 
auto-erotic inclinations to the mouth — as has been illustrated by the 
" sausage " already mentioned. As Ferenczi aptly puts it, the treat- 
ment, by the gradual bringing of these repressed impulses to con- 
sciousness, offers a most favorable condition for transference of 
these unsatisfied values upon the physician. 

" The analyst acts as a katalytic agent, which, in the decomposi- 
tion that takes place, draws the separated affects upon himself. This 
is, however, only a decoy, as it were, to lead the patient's interest 
back to the original buried sources and to establish a permanent 
connection with them." 

Ferenczi emphasizes the highly important point upon which I 
have dwelt at length earlier in these pages. A physician simply 
because of his being a physician stands in a specially favorable posi- 
tion for the transference. In the first place he stands for the pro- 
tective factors in the patient's unconscious and secondly, it is well 
recognized that the physician is regarded, from the standpoint of the 
infantile sexuality, as one who knows the forbidden and looks upon 
and touches what is concealed. 

It is a singularly striking fact that the dream material is so rich 
in these transfer phenomena relative to physicians and the beginning 
analyst must be particularly careful in his judgments concerning this 
transference material which is constantly appearing as directed upon 
previous trusted general or special practitioners. The analyst finds 
himself frequently substituted for formerly employed laryngologists, 
rhinologists, gastro-enterologists, gynecologists, etc. These physi- 
cians have in their turn been objects of unconscious sexual impulses 
which have been, mostly, repressed. They are now revived in new 
phantasies attached to the analyst. The latter, who should under- 
stand these phenomena, should eliminate the ever present infantile 
tendency to wish to criticize his brother physicians on the basis 
of the evidence derived from these phantasies, and moreover, he 
should not get disturbed when his equally infantile but not so know- 
ing brother physician roasts him on the spit by petty innuendoes or 
veiled slander. 

It is particularly futile for the analyst even to revile in his heart, 
let us say, the gynecologist whose genital manipulations are recog- 
nized from the patient's dreams to have been sources of auto-erotic 
gratification. It may be quite clear to the analyst why his gynecolog- 
ical confrere failed to effect a cure of the neurosis. But the gynecol- 
ogist should not be blamed for doing something which, unconscious to 

9 



Il8 THE TECHNIQUE OF PSYCHOANALYSIS 

himself as well as to his patient, had been a means of continuing, not 
curing the neurosis, because from lack of psychological insight he was 
not aware of what was really going on. It is all the more a matter 
of extreme importance for the analyst, who is supposed to know 
what is going on in the unconscious, to avoid the very selfsame 
faulty treatment although the manipulations may be symbolic rather 
than manual. 

The amazing ingenuity of the repression side of the unconscious 
to make plastic modifications of the symbols whereby secret gratifi- 
cation may still be retained is almost beyond belief. If the patient 
fails to get well or to radically improve, under the analyst's care, he 
must put it down as a fact, from which no amount of rationalization 
will let him escape, that he is failing to perceive his own infantile 
fixations and is committing, in minor or major degree, under dif- 
ferent symbols, the selfsame faults, so far as recovery of the patient 
is concerned, as the reviled gynecologist, internist, gastro-enterolo- 
gist, etc. 

This selfsame lack of sympathetic insight into the difficulties 
leads to numerous futile recriminations between physicians, which 
are unmistakable indices of failure. They point to the fact that the 
libido is not being used to comprehend. The old aphorism that 
" negation is a sign of the small mind " has its inception in the recog- 
nition of these psychological events. In similar vein is Leibnitz's 
well-known attitude when he writes in his " Monadology " that " he 
read books to find out what he could get out of them rather than 
what he could find to criticize in them." 

In this connection, we are led to the subject of the analyst's re- 
sistances, not only to brother practitioners, but more particularly to 
other analysts. The situation frequently arises when the analyst is 
asked to give his opinion relative to other analysts, as well as other 
physicians. I am in the habit of answering this question by prefac- 
ing it with the well-known statement of Protagoras already elab- 
orated in these articles " That truth and reality are to each man as 
he perceives them." Any opinion of mine, therefore, would be of 
value solely to myself and as helpful in resolving my own conflicts 
with reality. They can have no specific value for any one else with 
different conflicts and different settings. I frequently illustrate my 
meaning by referring to some like or dislike, of my own, relative 
to some article of food, some work of art or some musical compo- 
sition. My opinions concerning them are purely individual and per- 
sonal. So it is with Dr. So-and-So. He is a purely personal ex- 



TRANSFERENCE AND RESISTANCE II9 

perience for each individual. He will prove his own value and my 
own ideas concerning him are more a product of myself than they 
are a value of him for you. They are purely personal reactions and 
adjustments and have no particular value for other people and for 
other adjustments. 

It must always be borne in mind by the analyst that one's criti- 
cisms of others is usually a revelation of one's own conflicts and 
weaknesses, which the unconscious of the patient will grasp, retain, 
and utilize as a resistance to the getting at their own conflicts. 

Ferenczi still further calls attention to the hetero- and homo- 
sexual unconscious phantasies. If the physician is a man the uncon- 
scious heterosexual phantasies of the women patients are attached to 
him and serve to accentuate their repressed complexes. Every one 
has homosexual components as well and so he may positively arouse 
the male patients to sympathy and friendliness or, negatively, give 
rise in them to antipathies and dislikes. Feminine characteristics in 
the physician can stimulate the homosexual in the woman or hetero- 
sexual in the man and be a basis for transfer or resistance phenom- 
ena. 

The neurotic is constantly in search of objects upon which to 
transfer his feelings, and for those particularly who can be drawn 
into the circle of his interest. Ferenczi utilizes a special term for 
this, ifitrojection. He contrasts it with the typical paranoid mech- 
anism of projection. As a result one finds the contrasting types. 
The broad-hearted, sympathetic, excitable neurotic, easily aroused 
to hate or love towards the whole world, and the narrowed, distrust- 
ful paranoic, thinking himself pursued or loved by every one. The 
psychoneurotic suffers, as Ferenczi puts it, in the expansion of his 
ego, the paranoic in the contraction of his. Both of these end re- 
sults are obtained through exaggerations of perfectly normal mech- 
anisms. 

We have already spoken of the supposed dangers lurking in the 
transference. Possibly there are. I am not yet in a position to say. 
Ferenczi is one who denies any harm can come from the trans- 
ference. I am disposed to agree with him, if one can be certain 
that the transfer is going to be rightly handled by a conscientious 
analyst. 

There is danger in morphine and the surgeon's knife, but their use 
is not denied because of this. One must comprehend the agent in 
use. Without a proper handling of the transference successful 
therapy, although it may occur, is a hit or miss performance. 



120 THE TECHNIQUE OF PSYCHOANALYSIS 

Ferenczi maintains that only the positive feeling towards the 
general physician is recognized, because as soon as an unfriendly 
transference arises the patient separates from the physician, the 
positive transfer is overlooked by the unsuspecting physician and 
the successful issue of the treatment is ascribed to mechanical means, 
to pharmacotherapy, to osteopathy, Christian Science, or to sugges- 
tion. Neurotics almost invariably treat themselves by psychotherapy 
— by transference. Intro jection is a self-taught mode of healing. 
The patient uses the method if he comes to a well-disposed physician 
and attempts to transfer. If he succeeds improvement results. 

This, the natural way, accounts for many of the successes, partial 
at least, which are undoubted under every form of therapy, one 
might say, any form of therapy from downright charlatanism' to the 
most approved orthodox forms of medicine taught in the schools. 
It is not necessarily, however, the right way, or the best way, for 
as a rule the repression, displacement and transference, which the 
neurotic uses, do not ultimately succeed. Fully fifty per cent, of 
the neurotics and fully as many of the psychotic cases which I have 
investigated in the past eight or ten years were once " cured " by 
operations, by hydrotherapy, by Weir Mitchellism, etc. Their early 
conflicts were repressed through their early transferences to the 
many physicians who treated them, but the attempt at radical healing 
was essentially unsuccessful. They made very costly substitutions 
which, in later years, have destroyed them in part or totally. 

Psychoanalysis, Ferenczi well says, must individualize what na- 
ture spurns. The natural way does not always succeed. Psycho- 
analysis seeks to make the individual capable of life and activity, 
whom nature, indifferent to the feeble individual, would, through 
the repression, summarily destroy. 

It is not enough to displace a little further the repressed com- 
plexes by means of transferences to the physician; to relieve in part 
the affect tension, and to reach a temporary improvement. The 
patient must, by help of an analysis, come to the point where he will 
overcome resistances which prevent the sight of his own unadorned 
psychic physiognomy. 

One hears much of the value of suggestion and hypnotism in 
psychotherapy. The real basis of their value consists in their rela- 
tion to the phenomena of transference which we have been dis- 
cussing, hence they might be taken up here. 

On this point Ferenczi's studies are of much interest and valvie, 
and I purpose giving a full abstract of his important paper since it 



TRANSFERENCE AND RESISTANCE 121 

clears up many of the phenomena known to the earlier stages of 
hypnotic psychotherapy and casts an illuminating light on psycho- 
therapy in general. 

The phenomena of hypnotism have not been sufficiently explained 
either by the Parisian school — Charcot — or by that of Nancy-Bern- 
heim. The former considered peripheral and central stimuli, visual 
fixation of objects, stroking of the head, etc., as the chief factors. 
The latter considered such means as only the vehicle for the intro- 
duction of ideas, particularly of the idea of falling asleep, which 
would then permit a condition of dissociation of consciousness which 
would produce a susceptibility to further suggestions. 

Though this was a decided advance in the scientific treatment of 
the question of hypnosis, it did not actually explain the process of 
hypnosis. The external means seem inadequate to produce such 
profound changes in the human mind as result in hypnosis, nor does 
the introduction of the idea of sleep into the mind of a waking per- 
son seem sufficient to cause the necessary condition without some 
further aid. Everything seems to point to the conclusion that in 
hypnosis and suggestion the chief actor is not the hypnotist or the 
person offering the suggestion hut the patient, himself, who has 
hitherto been looked upon merely as the "object." The existence 
of autosuggestion and autohypnosis, as well as of limitations in each 
individual to the ability to be hypnotized, seems to point to the same 
conclusion. 

Psychoanalytic research has, however, given an insight into the 
mental processes which take part in suggestion and hypnosis. It has 
confirmed the opinion that the hypnotist " is relieved of the trouble 
of calling forth the condition of dissociation," for this condition, 
the existence of different layers of the mind, has been discovered to 
exist even in the waking state. Besides this, psychoanalysis has 
given us undreamed of knowledge of the content of idea complexes 
and of the direction of the affect, which constitute the active, uncon- 
scious layers of the psyche in the process of hypnosis and suggestion. 
The instincts repressed in the course of development are stored up 
in the unconscious and their unsatisfied, stimulus-craving affects 
are ready to transfer to any persons or objects of the external world, 
and to bring these unconsciously into relation with the ego, that is 
to introject. With these facts in mind it can be readily seen that 
the unconscious psychic forces of the subject appear as the active 
agent, while the hypnotist, once considered all powerful, becomes 
only the object of the apparently unresisting subject. 



122 THE TECHNIQUE OF PSYCHOANALYSIS 

The prominence of the parent complex among those that become 
fixed in the course of childhood and its fundamental importance in 
all psychoneuroses, is readily seen in the hypnotic phenomena. 

But it has already been emphasized that there is merely a quan- 
titative difference between normal and psychoneurotic psychic proc- 
esses. Therefore a suggestion given bv the hypnotist to another 
would set in motion the same complexes which are active in the 
neuroses. This is not simply an a priori hypothesis, but actual ex- 
periences in psychoanalysis prove it. 

The resistances upon which one comes in the analysis, and which 
temporarily retard the work of analysis, are shown in time to be 
reactions to an unconscious feeling of sympathy, which properly be- 
longs to other individuals but is in actuality directed toward the 
analyst. 

Sometimes the feeling of the patient amounts almost to adora- 
tion of the physician, again hatred, fear, anxiety toward the analyst 
seriously disturb the analysis. These all, in the unconscious, refer 
to various personalities in the life of the patient, of whom the patient 
is not then thinking. Thus the physician represents the whole 
series of persons to whom these affects, positive and negative, prop- 
erly belong, and in the course of the analysis the affects are gradu- 
ally traced to their source. There come first, those related to in- 
dividuals in the direct past of the patient, then unattached affects 
from the period of youth, phantasies concerning friends, teachers, 
heroes, and at last, after great resistance, those due to repressed 
thoughts of sexual, violent and anxious content, which are con- 
cerned with the nearest relatives, especially the parents. 

These things establish the fact, Ferenczi says, that in every 
human being there lives again the love-craving, therefore fearful, 
timid child, and that all later love, hatred and fear are transferences, 
or as Freud says, new impressions of the feeling currents, which 
were acquired in early childhood (before the completion of the 
fourth year) and later were repressed. 

This knowledge encourages one in the belief that the remarkable 
power, which the hypnotist exercises over the psychic and nervous 
resources of the subject, merely brings to light the repressed infan- 
tile, instinctive impulses. 

It has long been recognized that sympathy and respect favorably 
influence the receptivity of the patient. But what was not recog- 
nized without the help of psychoanalysis is the fact that these un- 
conscious affects play the chief role and also that in the last analysis 



TRANSFERENCE AND RESISTANCE I23 

they are manifestations of unconscious erotic impulses, which are 
for the greater part transferred to the physician from the complexes 
arising out of the relations of the child and its parents. 

The importance of sympathy and antipathy between hypnotist 
and subject has been generally recognized, but not the fact that they 
belong together and are psychic structures capable of further sep- 
aration into their elements. Their analysis reveals primary, uncon- 
scious erotic wish-impulses as the substratum upon which an un- 
conscious and fore-conscious psychic superstructure is built. 

The earliest layer in psychical development is that of the pleas- 
ure-pain principle, the compulsion toward direct motor gratifica- 
tion of the libido. This, following Freud, in part, is here called 
auto-erotism. This can scarcely be reached in the adult by repro- 
duction, it must be studied from its symptoms. The stage of object 
love, however, can be reproduced. The first love objects, moreover, 
are the parents. '•' 

All this leads to the assumption that an unconscious sexual atti- 
tude lies at the basis of every feeling of sympathy, and that when 
two individuals, of the same or of different sex, meet there is an 
attempt on the part of the unconscious toward a transference. If 
the unconscious succeeds in making this transference acceptable to 
consciousness, either in purely sexual form or in some socially per- 
mitted, i. e., sublimated, form, the feeling of sympathy arises be- 
tween the two. If the fore-conscious denies the unconscious posi- 
tive pleasure, various degrees of antipathy will arise varying with 
the strength of both factors. 

Ferenczi therefore states it plainly ; an individual's susceptibility 
to hypnotic or suggestive influence depends upon the possibility of 
transference, or more frankly stated, the positive, though uncon- 
scious, sexual attitude of the person to be hypnotized toward the 
hypnotist; the transference, however, like every object love, has its 
ultimate root in the repressed parent complex. 

Practical experience in hypnosis adds testimony to this view. 
Certain characteristics favor the hypnosis, such as an imposing mien, 
striking features, self-assurance, ability to command respect. Some- 
times the commands are given with sternness, or "surprise hyp- 
nosis " is induced by means which startle the patient. On the other 
hand, sleep is produced by means of a half-darkened room, absolute 
quiet, and so on, with gentle stroking of the hair, the brow, the 
hands. Some charlatans use chloral and bromides, to dope their 
patients, and thus attempt to bring about a transfer. 



124 THE TECHNIQUE OF PSYCHOANALYSIS 

These are two distinct methods at the disposal of hypnotism; 
the one rouses to involuntary obedience, the other induces to blind 
faith, the one uses fear, the other love. These two methods have 
been used by all professional hypnotists in the past, they have been 
used by parents for thousands of years. 

For who is it but the father, who is represented by the imposing, 
terrifying manner of the hypnotist, the father whom every normal 
boy would believe in, obey and strive to emulate? The gentler 
method, on the other hand, reproduces those scenes of tenderness 
repeated numberless times at the bedside of the child, through the 
fondness of the mother. 

Even such external aids as the ticking of a watch at the ear are 
such means as one would use to fasten a child's attention and do 
actually serve to recall infantile memories and emotions. 

The requisite, then, for effectual suggestion, of hypnosis, is this, 
that the hypnotist must be " grown-up " in relation to the individual 
to be hypnotized, that is, able to awaken in him the same feeling of 
love or fear, the same conviction of his infallibility, with which he, 
as a child, regarded his parents. 

Ferenczi insists here that this suggestibility is not a characteris- 
tic analogous to the psychical character of the child, but that the child 
in us still slumbers in the unconscious. Our childhood is constantly 
found in our dreams, and discovered in our infantile tendencies, 
performances, errors and in our wit. In our inm.ost soul we remain 
children throughout life. " Scratch the adult, and you will find the 
child." 

Ferenczi is in tfte position to confirm his conclusions by ref- 
erence to various patients whom he had first treated by hypnosis 
and later analyzed. The patient's own confession, but even more 
the further analysis, revealed the erotic character of the transfer- 
ence, which had given success to the hypnotic treatment, while the 
analysis went much further and plainly showed how the physician 
had taken the place of the parent, father or mother, in the parent 
complex, that in the ultimate analysis lay at the bottom of the dis- 
turbance, or had been at first a substitute for the later representa- 
tive of the parent in the course of the patient's life. 

There came to light in one case the compulsion of a " supple- 
mentary obedience," the compulsive heeding of the father's com- 
mand given in childhood, which Ferenczi looks upon as an explana- 
tion of posthypnotic carrying out of commands. In both cases it 
is difficult to explain the actions carried out, for in the neurosis a 



TRANSFERENCE AND RESISTANCE 125 

long repressed command is obeyed, in hypnosis, one given in a 
conscious state for which there is subsequent amnesia. 

It is only in the earliest years of childhood, when the child is 
purely auto-erotic, that the child feels the demands of his parents as 
an outward compulsion, and that they cause him a feeling of dis- 
pleasure. As soon as he reaches the stage of object love, the child 
identifies himself with his parents, he introjects the objects of his 
love, appropriates them to his Ego. He usually identifies himself 
with the parent of the same sex, and fancies himself in the same 
situations as that parent. Obedience is then pleasurable within cer- 
tain Hmits. If the demands of the parent extend beyond the bonds 
of love, the libido is prematurely turned from the parent and psychic 
disturbance is the result. 

The author introduces a striking example of this in the story of 
Peter the Great and his son Alexei. Here the father's extreme 
austerity, impressed upon the boy through many external charac- 
teristics and mingled with a passionate tenderness but rarely ex- 
hibited, exerted an overpowering influence on all the later life of 
the crown prince, driving him even to his death. 

This feeling of respect for the parents and inclination toward 
obedience is the source in later life of the same feeling toward 
teachers, superiors, rulers and all those in authority. 

Two cases difficult of treatment because of the strong fixation 
upon the father, who in each case was teacher, too, confirm Freud's 
conviction that hypnotic credulity and susceptibility are rooted in 
the masochistic components of the sexual instinct. Masochism is 
pleasurable obedience, which a child learns through his parents. 

The case of an anxiety-neurotic shows the analogy between the 
neurotic symptoms and so-called " term suggestion." A young offi- 
cer had entered service under pressure from his father. He had 
resolved, however, to leave the service at the end of ten years, when 
he might be pensioned. At the expiration of this time he had for- 
gotten his resolution and for various reasons he continued in the 
service. But it was at this time that the neurosis broke out. Not 
only did the analysis discover the relationship of this term of years 
to the outbreak of the sickness, but it carried it back to the childish 
relation to the mother, particularly to infantile phantasies concern- 
ing the term of menstruation and of pregnancy in the mother. This 
case confirms Jung's statement that "the magic, which binds the 
children to the parents, is the sexuality on both sides." 

Psychoanalysis can explain what seems to many as an absurdity. 



126 THE TECHNIQUE OF PSYCHOANALYSIS 

namely that a large percentage of healthy people can be hypnotized 
and so a condition of " artificial hysteria " can be produced in them. 
For psychoanalysis has discovered that all struggle with the same 
complexes, and that there is in every one a bit of hysterical disposi- 
tion, which favoring circumstances might develop into illness. The 
hypnotist can in fact produce no other phenomena than the neurosis 
produces spontaneously. In both, moreover, unconscious complexes 
determine the phenomena, and among these, the infantile and sexual, 
especially those related to the parents, play the greatest part. 

We may readily assume an extensive relationship between the 
mechanism of autosuggestion and psychoneurotic symptoms, which 
are the realization of unconscious ideas. Yet this is no other than 
the relationship that exists between the neuroses and external sug- 
gestion, because according to the foregoing hypothesis, there is no 
such thing as hypnosis through the introduction of an idea from 
without. What occurs is this, that the unconscious, preexistent, 
auto suggestive mechanisms are set in motion. The actual sugges- 
tion may be compared to the precipitating cause of the psycho- 
neurosis. 

The differences that may exist between hypnosis and neurosis 
form a problem for future investigation. It is sufficient to state 
here that the high percentage of individuals capable of hypnotism 
among normal people is an argument for the universal possibility 
of a psychoneurosis, rather than one against the similarity of hyp- 
nosis and neurosis. 

It may seem paradoxical that the resistances against hypnotism 
and suggestion arise from the same complexes which are the source 
of the transference, hypnotism or suggestion. Yet Freud has dis- 
covered this and confirmed it in many cases. According to his con- 
ception the inability to be hypnotized is an unwillingness for the 
same. There are neurotics who do not want to be cured. They 
have come to terms with their symptoms in such a manner as to 
secure, without self-reproach, unconscious erotic pleasure or other 
advantage, though in a costly or impracticable way. The second 
sort of resistance is found in the patient's antipathy to the physi- 
cian, the roots of which lie mostly in the unconscious infantile com- 
plexes, as has already been set forth. 

Other resistances which are discovered in the course of psycho- 
analysis appear also with attempted hypnotism. There are feelings 
of sympathy that are unbearable. The cause of much failure in 
hypnosis has been given by Freud as the fear "of becoming too 



TRANSFERENCE AND RESISTANCE 12'J 

familiar with the person of the physician, to lose one's independence 
toward him or to become sexually dependent upon him." Yet both 
the inclination toward hypnotism on the part of one patient, and the 
flight from being influenced in another, have their roots in the 
parent complex, especially in the manner of withdrawal of the 
libido from the parents. 

Another convincing example from the author's analytic work 
illustrates how a marked haughtiness, which prevented hypnosis 
and made a psychoanalysis difficult, was finally led back through the 
analysis to an experience in girlhood, when this haughtiness served 
as the only weapon against the father, and how this was in turn 
rooted in early infantile sources, highly colored sexually. 

Ferenczi states his conclusion tersely by saying that the subject 
is unconsciously in love with the hypnotist and the tendency for 
this is brought along from the nursery. Any ordinary love affair 
manifests the same phenomenon. A lover will perform almost in- 
voluntarily any act suggested by his loved one, even, it may be, a 
criminal one. 

According, then, to his conception, suggestion and hypnosis are 
the deliberate establishment of conditions under which a tendency to 
blind belief and uncritical obedience (a remnant of infantile erotic 
love and fear toward the parents) present in every one, but usually 
repressed by the censor, can be unconsciously transferred to the 
person who performs the hypnotism or offers the suggestion. 



CHAPTER VII 

Overcoming the Conflicts. Socialization [Integration] of 

THE Personality. The Use of the Dream in Handling 

THE Dynamics of the Transference-Resistance 

We are ready now to draw together some of the threads of the 
previous discussions. The goal, of the analysis has been broadly 
outlined as an effort towards socialization of the personality. This 
is accomplished by the taking away of libido, i. e., releasing it, from 
infantile fixations, and by stepping it up, if one might use an elec- 
trical phrase, to more advanced adaptations in the reality world. It 
is a form of teaching the patient to grow up. But, as has been seen, 
it differs from the usual types of pedagogics in that the dynamic 
factor, transference, is utilized to have the patient realize the old 
dictum of " Know thyself." This " thyself " is interpreted in the 
light that the real thyself is " unconscious " to the patient, and this is 
the cause for the persistence in maladaptations through the conflict. 
This conflict on the one hand (regressive) contains the sum total of 
century-old accumulated wishes to remain at a lower level of adapta- 
tions with their physical constitutional organic structural stabiliza- 
tions, and on the other hand contains the progressive urge of the 
spirit of life (spiritual some people term it) to bring about newer, 
better and more vitally valuable adaptations. These adaptations 
are preeminently social and make for the stabilization of the best 
values in society. The ideal of the true, the beautiful and the good 
is reached through a biological process of pragmatic racial wisdom 
equally as well as by means of an absolutistic fiat of a God. 

We have spread out before us the different parts of the "ma- 
chinery and have attempted to group them into large units or classes 
for the sake of ease in handling. The utilization of the evolutionary 
concept has beefi the most feasible concept in pursuing this general 
schematization. 

As the geological history of the earth has been patiently investi- 
gated, so too must the mental history of man be pushed further and 
further back. It will not suffice, as has been shown, to take the con- 
scious as the criterion for this history. The conscious is, in a man- 
ner of speaking, only a recent crust — only that which the cerebral 

128 



' OVERCOMING THE CONFLICTS I29 

mechanism permits to come out into the open to further the action 
now being performed. Behind it He the vast accumulations of past 
biological experiences which have fashioned man as he is, and are 
contributing to his becoming. 

In the language of geology, successive periods have their out- 
crops, their horizons. We speak of Paleozoic, Cenozoic, Mesozoic, 
and Psychozoic times, in each of which successive horizons are dis- 
tinguished, from the primitive archaic rocks to the most recent 
times. The principles which have governed the terminology of these 
periods have varied, but each of the main divisions has been named 
after some striking feature. Thus Silurian, Devonian and Car- 
boniferous, respectively, refer to reptiles, fishes and coal-plants. In 
certain places on the earth's crust almost the entire series of layers 
lie like a book opened to the observant eye. A " big hole " is all that 
some can see in the Grand Canon of the Colorado. Almost the 
entire geological history of the North American continent lies there 
revealed to the geologist. The former yawns and wonders whether 
it is worth while to go to the bottom and see the muddy river. The 
latter thrills with excitement and could spend a lifetime in working 
on the evidence. 

So it is with the cross sections of the human mind, of which 
one gets a glimpse in studying the unconscious. To the casual ob- 
server it is just a "big hole," but to the student of humanity it is an 
infinity of possibilities. It will be charted some day. As Adolf 
Meyer has well said, now that man has found the North Pole and 
the South Pole he may fit out an expedition to find out something 
about the human mind's possibilities. 

Will it not be possible to express the advances in the mental 
integrations in some such manner as has the geologist? For the 
purposes of psychoanalysis I have suggested some such scheme for 
four chief periods. At the base lie all those trends with which the 
human being comes fully endowed into life ; these are the inherited 
experiences of useful action, some as old as the beginning of life. 
To this level of the series the term Archaic may be applied. As yet 
no suggestions are offered as to a practical terminology of cultural 
horizons in this archaic period. In point of time it is the 100,000,000 
year accumulation which has already been defined (p. 40). The 
next period, more recent, may best be termed Auto-erotic^ — it is 

1 Dr. F. L. Wells has suggested autohedonic. Organerotic is a valuable 
term. It is the desire part which lies behind the " vital " action of an organic 
function. 



130 THE TECHNIQUE OF PSYCHOANALYSIS 

the period of individual organ integration. The terminology of its 
horizons will best be sought from comparative anatomy, comparative 
philology, comparative anthropology, etc. In a recent study I have 
tried to outline a horizon in this period which I have termed the 
Ovidian. It represei^ts the repression, for the race, of the bestiality 
motive. Animals as libido objects became libido symbols.^ For the 
third period the term Narcissistic has been utilized. Its highest 
horizon marks the integration of the individual as a social being. 
Anthropology must offer the terminology for subdivisions of this 
period. In this connection Osborn's " Men of the Old Stone Age " 
is illuminating. The Social period is the final period of this series 
and represents the past 10,000 years of man's socialization, during 
which an integration of the herd instinct has become more and more 
valuable. In history, art, literature, religion, etc., are to be found the 
terms for the symbolic periods. 

In a broad general way the unconscious will show outcrops — 
thought fossils — of all of these periods. The patient slowly and 
patiently learns what sort of a man he really is and wants to be in 
terms of his innermost striving. The dreamer who dreams / am 
alone on a desert island, Hawaii, Honolulu, etc., already quoted (see 
p. 84), is only turning up a thought fossil from the unconscious 
which lies in a stratum antedating her period of socialization. It 
is a narcissistic horizon, this desire for individual freedom, this 
wild desire to be free from any control, to play the game alone and 
according to her primitive desires. All the dreams will show in greater 
or less degree of moulding these thought fossil symbolizations. To 
integrate the personality by means of this incontrovertible evidence 
is the synthetic side of psychoanalysis. Analysis and synthesis pro- 
ceed side by side. 

In such a synthesis it may be of service to very briefly summarize 
the steps already traversed in detail. It may be assumed that a 
tentative sizing up of the situation has shown that the patient is suf- 
fering from a disorder which may properly be handled by a psycho- 
analytic procedure. (See chapters. What Not to Analyze.) The 
main resources of internal medicine have been utilized to guard 
against the mistake of attempting to do away with a definite somatic 
disease by psychotherapy, a mistake which, in passing it may be 
remarked, occurs much less frequently than the reverse — that of 
trying to treat a preponderatingly psychical product by surgery or 
internal medicine. 

2 " The Role of Animals in the Unconscious," by Smith Ely Jelliffe an 
Louise Brink, Psychoanalytic Review, Vol. IV, No. 3, 1917. 



OVERCOMING THE CONFLICTS I3I 

The patient has been encouraged to tell in detail the whole story 
in all of its social and personal ramifications. The significance of 
mental mechanisms in disease and particularly those in the uncon- 
scious has been told the patient and the method of using the dream 
as a road to the unconscious has been explained. The analysis then 
proceeds by the careful selection of those dream symbolisms which 
the transference features of the dream reveal as most acceptable to 
the patient's conscious point of view. 

What Sidney Lanier, the poet, has called the "little leaven of 
dream-taught wisdom " is discussed by the analyst with the patient. 
In certain patients the advance is at first very rapid. Dream after 
dream will reveal in clear and unmistakable manner what practically 
lies in the foreconscious of the patient ready for reappraisement and 
readjustment. Self-revelations may then proceed with startling 
alacrity. In others on the other hand the progress is extremely slow. 
Particularly is this true with usually older individuals, and in those 
whose protective devices are well rationalized. In these the re- 
sistance features already outlined appear very early, and make a 
strong contrast with the other trend where positive transference 
signs are numerous. 

One is comparatively soon in a position to attempt a graphic 
summary of the situation. This the analyst may do for himself or 
he may make it a matter of mutual study with his patient. In a 
manner analogous to a temperature chart he may attempt the in- 
finitely more complicated procedure of putting on paper an appraisal 
of the psychical trends of the individual, a psychogram as it were. 
Fragmentary and incomplete as such a record must of necessity be, 
yet nevertheless it may help him to objectify his work and afford 
standards of comparison in the dynamic progress of the case. He 
may thus watch and possibly record the progress of the cure, and at 
the same time by analogy offer some light on the character of the 
disease mechanisms which are under consideration. Such graphic 
charts may help the patient, but at all events in an article on tech- 
nique for beginners I feel they may be of help and therefore will 
phrase it somewhat as follows : 

The ideal may be assumed to be what has been termed a well- 
rounded character, that is, that the individual who has full command 
of his libido in all situations in life is, psychically speaking, the 
best adapted. In these pages it has been expressed as " full 
socialization of the libido through the process of sublimation." 
Such a " character " may be represented by the accompanying circle 



132 THE TECHNIQUE OF PSYCHOANALYSIS 

in which the outer circle represents complete social adaptation. 
Within this circle another is represented, embodying the grade of 
evolution to the narcissistic phase. Herein the individual's libido 
is taken up completely with self. His books, his money, his ideas, 
his clubs, his opinions, his family, etc., etc. Within this another 
circle represents the stage of organ values, the organerotic phases of 
evolution, while the central core of the graphic is taken up with the 
evolutionary period of the archaic. 

Thus from within outward one may construct an arbitrary scale 
of gradually advancing evolution towards complete socialization of 
the libido through archaic, organerotic, narcissistic to social goals. 
Furthermore, dividing the whole figure into sectors, one can in a 
way partly indicate this evolutionary scale in terms of the partial 
libido trends. 

A hypothetically ideally perfect character then would be repre- 
sented in the graphic by a perfect circle. Failure of complete social- 
ization of the libido (adaptation to reality) might be represented by 
indentation of the curve to such a phase as the individual character 
failure (fixation or regression) might indicate in any particular in- 
stance of conduct. The indentation is to be recorded in the partic- 
ular partial libido sector in which the regressive or fixed factor was 
most prominent. As the analysis proceeds it becomes possible with 
increasing exactness to make an outline of the character and thereby 
to determine, much in the manner of speaking of military strategy, 
where the weak salient is to be found, that is, to determine focal 
points in conflict (complexes) where energy is being diverted (fixa- 
tions) to useless phantasy ends. 

A partial plotting of a few cases will illustrate the mode of work- 
ing of such a scheme. As it takes may be months to get all the 
information, the purely schematic nature of these charts will be 
evident, but they are used to show what psychoanalysis tries to do. 
Leaving out of consideration a number of other neurotic signs, the 
patient first illustrated shows two very clear ones which in the 
diagram are presented in the partial libido sectors of the eye and the 
bladder. Thus in the eye sector one observes a definite dipping 
down of the graphic corresponding to a fixation of the libido at the 
narcissistic level. This corresponds to a definite symptom. When- 
ever this patient for instance is riding in her automobile, and an- 
other car seems to be coming too near, suggestive of colliding, the 
response is a compulsory shutting of the eyes. This means that 
a thing cannot happen if she cannot "see" it. That is what she 



OVERCOMING THE CONFLICTS 



133 



cannot "see." This is a typical narcissistic manifestation, which 
further results in her shutting her eyes to facts which she does not 
wish to see, and also her ears to things which she does not wish to 
hear. She does not regress here down to the organerotic level, as to 
make her eye organ actually blind or her ear organ deaf (psychic 




Fig. I. Schematic representation of fixations of libido in one patient. 
The dip in the respiratory sector representing a psychogenic asthmatic de- 
fense reaction in an Individual continually talking of self ; in the eye and 
ear sector refusing to see or hear truth and reality; in the genital, urinary 
eroticism. The deep incision in a fairly well socialized nutritive libido rep- 
resents an emotionally condltoned capacity for selective rumination of indi- 
vidual ingredients in the stomach. A severely sick individual on the border 
of a psychotic reaction. Present nosological schemes would call this anxiety- 
hysteria or a manic-depressive psychosis If the compensation should break. 



blindness and psychic deafness), as this might cripple too much. 
Thus in the plotting of the symptom the curve only descends to the 
narcissistic level. 



10 



134 "^^^ TECHNIQUE OF PSYCHOANALYSIS 

In the bladder-rectum sector, however, one notes in the diagram 
a deeper sinking of the curve to the auto-erotic level. This corre- 
sponds with an extremely striking symptom which consists in a loss 
of control of her bladder. Thus the same patient, also in her car, 
is, let us say, held up by the congested traffic on the street. Being 
in a hurry, she becomes very impatient until finally she has an invol- 
untary passage of urine. This mode of response has been going on 
for so many years that it has become her habit always to wear a 
cloth. Here the phantasy way of overcoming the difficulty is at a 
more elementary level. It goes back to the bladder power sense 
(organerotic Jehovah) which has been discussed in these articles 
(see p. 40). The patient, in phantasy unconscious auto-erotic fix- 
ation, triumphs over the necessity for self-control in being held up 
by the traffic, and asserts her mastery by the symbolic early and 
necessary mastery acquired over the control of the bladder. 

One would by the law of ambivalence, which has also been dis- 
cussed, expect to find this patient excessively keen-sighted to find 
faults in others, remarkably acute to hear the least verbal equivo- 
cation, and to be excessively neat and minutely clean with reference 
to her bodily secretions. Such is the inevitable law of psychical 
over-compensation and the contradiction in the conscious acts and 
the unconscious phantasies. 

Now such a graphic shows the point of attack. The dreams 
show the great impatience of this patient — great rapidity with which 
everything is done — and also at times the urinary and eye symbols 
appear in the dream and permit the discussion, i. e., the attempt at 
straightening out the salient, in the evolution of the psyche. 

For instance this patient is too impatient to read. She can not 
stay quiet long enough. Naturally she will not remember what she 
reads. The task, therefore, of the analysis is to get at the tied-up 
phantasy satisfaction that these graphic dips indicate. To bring 
into consciousness the fact of this form of self -worship (narcissism) 
through rejection of the things seen and heard, which by the way 
in which they are handled by the patient prevent in her the growth 
of character. Such trends when continued too long result in dis- 
ease of a minor or major nature, an idiosyncrasy, a psychoneurosis 
or a psychosis, or even a grave physical disorder, depending upon 
the number and depth of these fixations. 

Thus in an otherwise healthy graphic one detects only a few of 
these dips into earher levels of adjustment. For the purposes of 
illustration take Webster's habit of compulsory toying with a button 



OVERCOMING THE CONFLICTS 



135 



on his coat while speaking (narcissistic tactile phantasy). One 
speaks of it as an idiosyncrasy. In the case just cited, however, 
where one has eye, ear, bladder, stomach and other fixations, one 
makes a diagnosis of hysteria — partly by reason of the number of 
the failures of the partial libido trends to socialize, partially be- 




FiG. 2. Schematic psychogram of unconscious trends as shown in the 
dream wish. Markedly reduced interest (shut in character-introversion) and 
low dips into archaic forms of libido phantasy. Cannibalism ( ?) and food 
fertilization symbols apparent. Nosologically speaking, a dementia prsecox 
seen from the dream level. Illustrating the value of the dream material for 
diagnostic purposes. This patient at the conscious level was thought of as 
" neurasthenic." 



cause of the deep level of the regression. When the level of the 
regressions is low (archaic or organerotic), then one nosologically 
speaks of a manic-depressive or dementia prsecox. 

Thus for another patient I would make a schematic graphic, this 



136 THE TECHNIQUE OF PSYCHOANALYSIS 

time utilizing the dream material rather than the symptoms to show 
how the turning up of a deep level thought- fossil in the dream may 
throw light upon the probable diagnosis. 

This patient, referred to me by her much older husband, a physi- 
cian, was a young woman much interested in economic and social 
problems. She had been attending lectures and had complained to 
her husband of failure in her ability to concentrate. He said she 
had not been as well as usual and had been treated in her home town 
for a few months for neurasthenia. She had had a Weir Mitchell 
rest cure and was still somewhat indifferent and listless when he 
brought her to me. This was about all I learned, save in greater 
detail as to the treatments, what the different doctors had said, her 
home situation, etc. She was alone and of independent means, and 
I recommended a week's observation, as outlined in the early part 
of these articles. On the fourth or fifth interview she brought the 
following dreams : 

1. / am reading a newspaper. There seems to he some announce- 
ment in it and I find myself going downtown where a group of people 
are assembled, with which assembhge the announcement in the paper 
seems to have some connection. We are all looking into a two-story 
frame house, like a house on the stage with the side removed, and 
on the second floor there is a large woman, and she is apparently 
making soup for the crowd. I see the hones of a man's chest in the 
soup pot and am curious. 

2. / am seated hy the seashore on the sand naked and there are a 
lot of people walking about. I am quite at my ease. I notice that 
the ocean stands up like a wall about six feet high and projecting 
from it there is an ear of corn which I commence to eat with relish. 

There are too many things in the dream to attempt to plot them 
all on the scheme, but in the stomiach partial libido sector — soup and 
ear of corn which is eaten — and in the eye libido sector — the seeing 
of the chest in the soup pot, and being naked on the sand — are to 
be found thought-fossil horizons worthy of comment. In both 
dreams, there are many people, which is a more or less universal way 
of saying large unconscious demand, and hence in terms of ambiva- 
lence, known to hut few, i. e., in the Freudian terminology, ''a 
secret!' This large unconscious demand, the libido, can be checked 
off on the nutritive sector at a very primitive level, archaic, for both 
dreams. 

In the former dream it deals with eating soup of human flesh, 
i. e., cannibalism, one might say. This is a primitive wish which, 
while conscious, uncontrolled, and natural in a few of the most 



OVERCOMING THE CONFLICTS 1 37 

primitive of tribes, has little place in the present cultural horizon. 
In the second dream primitive customs are again seen. Whereas 
on the surface of the dream it deals with a fellatio phantasy, at a 
deeper symbolic level, it deals with the early childish, she was naked 
and not ashamed in the dream. Her libido is here occupied with a 
period in regressive phantasy before modesty and the sense of shame 
had arisen, and she was eating a sexual symbol. Fertilization by 
means of food stands out (see case of Zenia X.) indicating an 
archaic stage of the relations of sexuality to fertilization. No 
matter how socialized this patient's libido may have appeared 
on the surface, in the unconscious there were very marked ani- 
mistic trends, archaic they are here represented, and the graphic 
would have to show a very deep gash into the very center of the 
circle. On the basis of this evidence chiefly a diagnosis of dementia 
prsecox was made. The further progress of the case bore out the 
diagnosis and prognosis given at this time. 

Just as the archaic preoccupation in the unconscious is recog- 
nized as a deep regression and can be so charted, so also dream 
symbols of reduction of the libido may have a sinister significance 
and call for special caution. 

Thus in the analysis of a patient suffering from pathological 
blushing with other things, the following fragment of a dream was 
obtained : First I am on an ocean liner, and then in a row boat with 
my father and mother and sister, on the inside of this liner. I 
manage to get out through a porthole, it is very stormy, and I am 
now on a raft with my sister tossing in the angry ocean. Finally I 
am on a desert island with my sister. There are two wild animals 
attacking her, rhinoceros, hippopotamus, and I kill one of them. 

The first feature here is the striking reduction of the libido sym- 
bols, large liner, row boat, raft, desert island. Then there is the 
death of the libido symbol, the killing of the rhinoceros, i. e., a 
wild libido relative to the sister (incestuous phantasy). Further 
the archaic symbolism of being within the larger vessel may have 
some relation to an intrauterine skin phantasy — his blushing was 
all over his body. The evidence pointing toward suicide was over- 
whelming. At a critical period in the patient's life (marriage of the 
sister) regression was complete and he suicided. 

At this point it becomes necessary to say a word about the sym- 
bolism of the dream. Much has been written on symbols. I refer 
to White's article in Psychoanalytic Review, Vol. Ill, No. i.^ The 

3 Mechanisms of Character Formation, a work which every beginner of 
psychoanalysis should read 



138 THE TECHNIQUE OF PSYCHOANALYSIS 

various works already quoted in these articles have much to say 
"relative to symbolism. In touching on symbolism it should first be 
insisted upon that every symbol is a purely relative matter with each 
patient. I must remind the reader of the origins of language, and 
emphasize the fact that without a grounding in the principles of the 
evolution of language little headway will be made in the scientific 
comprehension of psychoanalysis.* 

No one has stated the fundamental fact as well as Bergson when 
he says that the latent root of language in the infant is that "any- 
thing may mean anything." To use Pawlow's phrase, every word 
becomes a conditioned reflex, and in the language of psychoanalysis, 
the term " complex " is a certain definite series of these conditioned 
reflexes. Thus in Pawlow's experiments the dog is shown food, and 
saliva and gastric juice flow. Later a bell is rung and an association 
formed. Later a ringing bell without food will determine the flow 
of gastric juice. It could have been a whistle as well as a bell or 
anything else. So with the beginning of the conditioned reflex of 
Pawlow, "anything can mean anything." In one dog bell ringing 
equals food, in another, maybe, whistle blowing, etc. So associa- 
tions are built up in different animals (people) through different 
experiences, i. e., different symbols. Whereas anything may mean 
anything for the beginning child or the experimental dog, the whistle 
has no effect on the bell ringing dog and vice versa ; hence the neces- 
sity for determining the exact symbol and its primitive "conditioned 
reflex " trend ; its earliest associations and their affects. This is as- 
certained in the patient solely by analysis. They themselves slowly 
learn from their own recollections as they go further and further 
back what the relations are between the " food and the bell," or the 
" anything and the anything." Thus in the dream just narrated why 
should 'this patient use "rhinoceros and hippopotamus"? What 
did they mean to himf 

The critic of psychoanalysis is constantly puzzled about dream 
symbolism. L. H. in a recent review of Maeder's Dream Problem^ 
thus says that " anything can mean anything to the psychoanalyst," 
in which he misses the important point that this is true, but true in 
the sense just related, that "everything means something'' and the 
analysis tells what it does mean to the individual patient. The 
analyst never knows until the patient establishes the development of 

* See Jung's Psychology of the Unconscious ; also Silberer, " Symbol- 
bildung," 1. c. Kleinpaul, Sprache ohne Worte. 

5 Journal of Abnormal Psychology, August, 1916. 



OVERCOMING THE CONFLICTS 1 39 

the symbolism. Increasing experience may aid him to see certain 
groupings and trends, just as a botanist can see the relationships of 
two plants, one an herb and the other a tree, which, in spite of appar- 
ently gross dissimilarities, are nevertheless intrinsically closely 
related. 

Thus an anthropologist might guess that when a patient dreamed 
that ''she was having coitus with her husband while she was uiv- 
well," she was hoping that her husband might die. Because he 
knows that for many primitive tribes all over the earth's surface 
the touch, even the seeing of menstrual blood, is held to be very 
dangerous to man, to crops, to food, etc. For the analyst to a 
priori assume this interpretation would be foolish. But when in 
addition to the anthropological knowledge that this is a widespread 
primitive belief, and from the patient herself, in the analysis, he 
learns of her ideas about menstruation, which going back to infancy 
establish the identically same or closely related fact, he is then per- 
mitted to assume an archaic symbolism in the dream and to draw his 
conclusions from it. 

So in the case of the rhinoceros and hippopotamus, when one 
finds from the patient's own associations the coarse jokes relative 
to " rhinos " and " sore ass " and " pot muss " and then also finds 
infantile urinary and fecal phantasies, and nursery monkey tricks 
relating to this very sister, then one can realize that the " reproach " 
of the unconscious which lay back of his blushing contained certain 
non-sublimated affect values which by reason of their constant at- 
tempts at expression caused his neurosis and his suicide. 

When for the psychoanalyst the wild animal is a generic type for 
wild and reprehensible libido, it must be remembered that this can 
only be utilized when backed by the patient's own associations. To 
prove this for every case reported would be too tedious for the most 
enthusiastic readers and a complete analysis would occupy many 
volumes. Frazer has written twelve volumes on the symbolism of 
the one symbol, the mistletoe. A complete analysis would fill a 
library. Therefore in reporting a case the analyst can hit the high 
spots only. This subjects every reported fragmentary analysis to 
criticism. To all so inclined the footnote on the first page of 
Leibnitz's famous work on philosophy, Monadology, might be 
quoted. " It is characteristic of me to hold opposition as of little 
account, exposition as of much account, and when a new book comes 
into my hands I look for what I can learn from it, not for what I 
can criticize in it." 



140 THE TECHNIQUE OF PSYCHOANALYSIS 

Symbolism is at the same time the most difficult and most fasci- 
nating part of analysis and tests the therapeutic possibilities of the 
analyst more than any other feature, for with the advancing sub- 
tlety of the unconscious to guard itself, i. e., to hang on to earlier 
phantasy formations, the symbolism becomes very intricate, and 
unless the patient will give free associations the meanings will be 
most ingeniously concealed. One must therefore stick to the free 
associations and never leave them to arbitrarily thrust in one's own 
interpretations. These latter are the analyst's associations, his con- 
ditioned reflexes, his " food-bell " associations, not the patient's. 

Whereas the individuality of the symbols must be insisted upon 
as a cardinal principle, yet there is enough evidence to show that 
certain groups of related symbols are very widely used and deter- 
mine group reactions. Just as one may recognize Chinese, English, 
German, French and Italian as certain symbol groups employed by 
great units of people in which the similarities of English and Ger- 
man have a common Teutonic root, of French and Italian a common 
Latin root, and all four a common Sanskrit root, whereas Chinese 
is evidently very distinct from all, so one will find the unconscious 
of many people using root symbols, as it were, meaning by them 
identically the same thing. This is only in line with the whole evi- 
dence bearing on the great principle of evolution, which receives 
much interesting confirmation, even explanation, from the uncon- 
scious handling of symbols. 

Thus in the opening pages of this volume I spoke of the patient 
who could not say negro but substituted " booey " man ; who could 
not hear the word " snake " without being frightfully agitated, but 
could use the word " serpent " ; who put white papers on the closet 
floor saying, " all must be light," but could' not look at a pipe, a 
cane or an umbrella nor step over a hose. Here by the aggregation 
of symbols it becomes evident, to the psychoanalyst at least, that the 
sexuality of the dark fearful (negro) thing in her life which must 
be made light (white paper in the closet), the snake, cane, hose, 
umbrella, pipe, all are " conditioned reflexes " to the thing " penis." 

This patient would have to be analyzed as any other and no 
amount of telling her what the symbols meant would cure her. That 
knowledge must come from the inside, otherwise why all the uncon- 
scious defence which so eft'ectually "reveals what she would con- 
ceal " ? Thus the analyst comes to a knowledge of the symbol values 
at the same time as the patient and only by patiently asking : What 
comes to your mind ? what then ? what does that suggest ? what do 



OVERCOMING THE CONFLICTS 14I 

you think in reference to your first impressions relative to this, etc., 
etc., that is, by the method of free associations. Then the patient 
himself learns why he does not like clams, or cannot eat scallops, 
and why he is always late or always misspells, or forgets names or 
gets disturbed under such and such conditions. As has been said 
every little action in life has determining causes. It may be inex- 
pedient or useless to analyze them, especially for those whose 
libido is sufficiently free to constitute what is pragmatically assumed 
as " normal," but for the neurotic, many of whom may be valuable 
people for the community, attempt should be made to find out why 
things mean what they do and how have they come to be. 

In the course of an analysis a large number of small mistakes 
in pronunciation, in word misplacements, apparently trivial forget- 
tings, mistakes of action, etc., will come up. These are very im- 
portant clues to unconscious complexes. Freud's work on the " Psy- 
chopathology of Every Day Life " should be consulted relative to 
these. 

This work cannot concern itself with the details of symbolism. 
I have spoken of the individuality of symbols, but a word may also 
be said about generalized symbols — standard symbols, which are 
more or less universal. Such may be found in the work of Freud 
on the " Interpretation of Dreams," and in Stekel's large works on 
" Die Traume " and '* Die Traume des Dichters." I shall mention 
here only some of those of more general interest, particularly those 
which frequently appear and which have a special interest as sym- 
bolizing the male and female sex, and the object and aim of the 
reproductive instinct. 

Thus the patient's own body is most frequently spoken of as a 
house. Nakedness of the body is frequently indicated by clothing, 
uniforms, draperies, hangings, nets, etc. Parts that show through 
are peeping and exhibitionism symbolisms. The male body is sym- 
bolized by flat things, the female body by irregular ones, mounds, 
hills, rolling landscapes, etc. Climbing on flat surfaces, or balconies, 
indicate these differences. 

The sexual act is largely symbolized by those types of movement 
which contain alternations of parts of the body or rapid backward 
and forward movements. Thus running, up or down stairs, dancing, 
swinging the arms, artificial respiration movements, playing the piano, 
swinging in a swing, or hobbyhorse, or ticking of a clock, metronome 
striking, etc. Much will depend upon the relations of the parts in 
the dream whether this symbolism is a true coitus wish or only a 



142 THE TECHNIQUE OF PSYCHOANALYSIS 

masturbatory wish. Thus five-finger exercises on the piano is fre- 
quently a purely masturbatory wish. Not infrequently the coitus 
is represented as a masturbatory type of coitus. For it should be 
remembered that much coitus has a masturbatory character. Thus 
a coitus as expressed as going up a pair of stairs usually has a more 
ethical significance than one going down a flight of steps. The 
figure 3 is frequently used as a coitus symbol. It is used for other 
purposes as well. Thus one patient — 3, mild schizophrenic — states 
consciously she goes up three steps and stops, then three steps and 
stops, for if she does not she will not have a movement of the bowels. 
She is stating in a symbolic way — " with coitus she can have a baby '* 
— the movement of the bowels referring to an infantile fecal birth 
phantasy. 

The male organ is frequently symbolized as something long and 
thin — a dagger, umbrella, stick, cane, tree trunk, pillar, barrel, re- 
volver, arrow, asparagus, banana, pear, corn cob, reptiles, fish, snakes, 
etc., etc., rain pipes, leaders, sprinkling pots, coffee pots, etc., often 
symbolize the male organ; the female genitals as muff, bag, box, 
chest, purse, pocket, chair, bed, hole, cave, church, crack, center of a 
target, windows, doors, small rooms, cellar. The figure two is a fre- 
quent female symbolization. Hairy animals may be either organ 
as determined by the size and character. Fear of touching a dead 
bird in one patient was a definite masturbatory symbol. Playing 
with kittens another. Castration and masturbatory phantasies 
(fellatio and cunnilingus) are frequently associated with losing a 
tooth. 

Potency and impotency symbols are frequently represented by 
flying machines, Zeppelins, balloons, trees standing or falling, pil- 
lars standing or falling (Sampson). Flying is a frequent erection 
wish. Losing trains, or boats or busses or things — ^these are fre- 
quent impotency symbols. 

Birth symbolisms center about water; going in or coming out; 
saving people, animals, objects from the water. 

Death wishes are represented by reduction of the libido, going 
into the dark, going away, on journeys, on the railroad, boats, etc. 

These are but a few of the more standard symbolizations, more 
precise details concerning which must be sought for in the works 
mentioned. 

Kaplan In a recent valuable work on the Fundamentals of Psycho- 
analysis^ has some very practical suggestions relative to the subject 

^ Grundzuge der Psychoanalyse, Vienna, 1914. 



OVERCOMING THE CONFLICTS 1 43 

of dream symbolism, some of which I here utilize, in free transla- 
tion, as they are apropos at this point. 

He reemphasizes that the language of the unconscious is a sym- 
bolic or picture language. Much conscious language is also purely 
pictographic. It is important then in the dream to attempt to piece 
together this conscious and unconscious use of the symbol through 
the common and distinctive features of both. 

" Thus the hand hollowed like a ladle is a gesture for a drinking 
vessel and is based upon immediate association, but the Indians make 
the same gesture to express 'water.'" "Thus the plastic image 
of the horned bull's head may for the Neapolitans express besides its 
immediate meaning of strength, as the main peculiarity of the bull, 
first, danger, particularly that of being assailed by an angry bull, 
next danger in general, and finally by a third displacement, the ' wish 
to be protected from danger.' "^ The symbols of the conscious life 
are quite as ambiguous as those of dreams and myths. '* In sign 
language of the deaf mute it is not said : ' He died because he was 
addicted to drink ' but * drink, drink, die.' The signs for drinking 
are several times made, then as sign for death the head with closed 
eyes is laid on the right hand and a gesture made toward the ground 
indicating ' sleep down there.' "^ That means that Every separate 
symbol has a certain indefiniteness, and only from the interrelation 
of the symbols can their sense be perceived. Another common 
quality of the conscious (purposive) and the unconscious (purpose- 
less) symbolism is that they both express only the present; extent 
of time has to be inferred. That accords well with the evidently 
sensational nature of the symbol; everything sensational belongs to 
the present. 

Those who cannot avail themselves of sound language resort to 
sign language ; deaf mutes and strangers who are unacquainted with 
the language of a country; likewise children are forced to seek the 
help of gestures in order to be understood. The gesture is in one 
sense the language of the mentally weak. But that is true of every 
form of symbolism. "(The pictures) are the more desired and 
more eagerly sought the more a concept is removed from sense per- 
ception and the more a suitable image fails to represent it. 

"When for example a speculative savant thinks of the world, 
or more correctly the undeveloped universe containing in itself the 
germs of all things, as an tgg ... if the Roman emperor holds a 

^ W. Wundt, Volkerpsych., Vol. I, Part I, pp. 171, 172. 
8 lb., p. 195. 



144 THE TECHNIQUE OF PSYCHOANALYSIS 

ball in his hand as the sign of world power, the globe in miniature 
... or if one of the church fathers wishes to grasp the divine 
Trinity in the schema of a visible triangle or a sounding harp, when 
he knows no better representation for eternity and the continuous 
recurrence of human things than a snake with its tail in its mouth, 
then the metaphysical concepts God, world, globe, eternity. Trinity, 
etc., force the imagining spirit to this conception and flit before him, 
nebulously trouble and pain him like mere outlines, until he masters 
them by means of a clear picture."^ 

Even an abstract science like mathematics, Kaplan significantly 
points out, had to go through a sensational-symbolic phase. The 
concepts of differential and integral calculus, which modern mathe- 
maticians have learned to grasp as abstract relations, and most of the 
analytical statements were at first fixed with the help of surfaces 
bounded by curved lines and with operations with such geometric 
figures. Strict mathematicians now regard it as an outrage in pure 
analysis to get any help from concrete geometry. If the origins of 
symbols in the line of evolution are studied, they are seen to originate 
when man intellectually grasps at something that his power of com- 
prehension finds too remote. Conversely the symbol may also 
originate if his former higher power of comprehension is reduced 
(for example in dreams and in mental disorders). In both cases 
he gradually slips away while trying to catch the idea lying at the 
bottom of the symbol and falls into a lower form than is striven for 
by evolution.^^ 

The symbols employed by consciousness, as they have an ex- 
planatory function, must be of a material character. They must 
readily bring to consciousness the relation with the thing that they 
are supposed to indicate. For example, Kleinpaul tells the follow* 
ing : " In German village inns I recall the laconic notice, ' No pump- 
ing (credit) here ' but instead of the word pumping a picture of a 
man pumping water." What the pumping meant was clear to every 
one. Quite as clear are the so-called legal symbols. Thus in olden 
times "the setting of the foot on land or other property was a sign 
of legal possession "^^ or " the old Norse scotation consisted in a little 
earth from the purchased or pledged land being shaken or thrown 
into the fold of the coat or cloak of the new owner; that assured him 

9 Rud. Kleinpaul, Sprache ohne Worte, pp. 24, 25. 

^•^ Herb. Silberer, Ueber die Symbolbildung, Jahrbuch, III, 675. Silberer's 
work, which is very valuable in this connection, should be consulted. 

11 G. Sartori, Der Schuh im Volksglauben, Zeitschr. d. Ver. f. Volks., Vol. 
4, p. 173- 



OVERCOMING THE CONFLICTS 1 45 

possession. "^^ (Representation by sample.) It is a concrete repre- 
sentation of the transfer of the right of possession, which may be 
quite comprehensible to every one. 

Picture language is the clearest of all, provided it is understood. 
Yes, provided it is understood ! And who can say that he has rightly 
understood? . . . Whoever speaks in pictures (figures) always has 
the advantage, that he appeals to the understanding of others and 
may eventually change this understanding into doubt. An advan- 
tage often used !^^ This advantage is taken by the unconscious which 
employs the symbols not to make clear, but on the contrary to 
substitute. Closely connected with this is the fact that most (ex- 
planatory) symbols of the conscious life have still a hidden sexual 
meaning. (They are therefore overdetermined.) Setting the foot 
on the land is a sign of taking possession, this legal gesture having, 
however, a less innocent sense. For "We take it as a sign of 
possession if the lover secretly steps on the foot of his adored, or 
the bridegroom on the bride's."^'* The significance of the earth as 
mother earth, as symbol of woman, is widely recognized. Here ap- 
parently is another case where the original sexual sense (the posses- 
sion of the woman) is translated into the harmless (as a legal 
symbol). In any case it should not be forgotten that the concrete 
sexual relation has always existed, but on the contrary the legal rela- 
tion of private property in land arose comparatively late in the 
history of man. 

"If it is said that in order to forget anything as soon as thought 
of, one should throw his slipper back over his head, that is quite 
likely a symbolization of doing away with the power of remember- 
ing.^^ Here the symbolizing action is of a purely materially de- 
scriptive nature. But it is surprising that a slipper should be 
thrown; why just this object? The answer is easy, if it is con- 
sidered that if one wishes to be free from an unhappy love one 
scrapes the dust from the heel of the right shoe, puts it in the shoe 
and throws it from a water-way backwards over the head into the 
water and goes home without looking around. "^^ Every charm for 
forgetting was probably originally a means of avoiding unhappy 
love; the action symbolized the departure of the sexual object. 
That the slipper symbolizes the female genitals is fairly universally 

12 J. Grimm, Deutsche Rechtsalterthumer, 4th ed., Leipzig, 1899, p. 161. 

13 Rud. Kleinpaul, Sprache ohne Worte, p. 307. 
1* G. Sartori, 1. c, p. 153. 

15 lb., p. 153. 

16 Wutke, Deut'scher Volksabergl., p. 555. Cited by Sartori, ib., p. 760. 



146 THE TECHNIQUE OF PSYCHOANALYSIS 

recognized. Thus in Fr. Miiller's Faust: "He would be pleased^^ 
to be the slipper mender (paramour) of the Queen of Arragon." 
Also the expression, a slipper hero, under the slipper, etc/^ 

Many expressions are intelligible only when they are exposed as 
symbols of the unconscious. So, for example, in Ruppin it is said 
to one who has forgotten something: "You have surely stubbed 
your big toe."^^ Stubbing the big toe is frequently the same as 
masturbating. In every expression a deep psychological sense lies 
hidden. Whoever has formerly practised many auto-erotic gratifica- 
tions, infantile masturbatory types, not necessarily genital, and then 
has repressed this fact from consciousness, becomes forgetful, be- 
cause the wish to forget becomes generalized and is displaced also 
upon indifferent matters. Here is a source of much forgetfulness 
among children and adolescents and bad school work. Pfister's work 
already referred to is rich in the analysis of this type of material. 

Kaplan further calls attention to Semi Meyer's criticisms of the 
psychoanalytic method, which are quite in line with those of L. H. 
already cited. "Everywhere an associative substitute is at the 
earliest possible moment dragged in by the hair. Why does that 
happen in dreams? Nothing of the kind occurs in waking life."^^ 
To that it may be replied that the critics are not acquainted with 
everyday life, as it is revealed in morals and customs, in law and in 
religion, otherwise they would not make such statements. In Frank- 
furt if " in pledging a piece of land a bag of earth is brought before 
the court and laid on the deed,"-^ the bag of earth is probably to be 
regarded as a representative of the pledged piece of land. Still more 
remarkable is the " Clagefurt custom of hanging the thief first and 
investigating afterward."^^ Crime must be expiated ; that is clear to 
the primitive man, and so they hang the first man that comes along, 
in order to satisfy their desire to make some expiation. The hanged 
man appears to be the substitute (symbol) for the actual thief, who 
has probably succeeded in escaping justice. Such things are worked 
out in old historical times, to be sure, not in dreams of course but 

1'^ Grimm, Deutsches Worterbuch, VII, Sartori, ib., p. 158. 

18 In a " Jugend " poet I found the sentiment, " New shoes and new lovers 
are uncomfortable." See also slipper symbolism in Hazelton and Benrimo's 

"Yellow Jacket." Analysis of this by Jelliffe, New York Medical Journal, 
1907, and Kempf, Psychoanalytic Review, October, 1917, Vol. IV, No. 4. 

19 Maxims and Expressions from the County of Ruppin. Collected by 
K. E. Haase, Zeltschr. d. Ver. f. Volksk., Vol. 2, p. 439. 

20 Semi Meyer, Zum Traumproblem, Zeitschr. f. Psychol., Vol. 53, p. 223. 

21 J. Grimm, Deutsche Recht'saltertiimer, p. 159. 

22 lb., p. 531. 



OVERCOMING THE CONFLICTS 1 47 

in actual life. The Westphalian expression, " The crow has brought 
me a nut " means " I have got a husband."^^ It is clear that even 
in waking life, if not so frequently as in dreams, "an associative 
substitute is at the earliest possible moment dragged in by the hair." 

Herbert Silberer has shown that the sensational-symbolic repre- 
sentation of thoughts can be to a certain extent artificially produced. 
If in a fatigued condition, especially before going to sleep, one 
forces himself to follow the thread of a (theoretical) thought the 
abstract relations will take on a concrete form and will cause an 
hallucination.^* A trial of the experiment leads one to suppose 
that the phenomenon depends on an individual factor, as not every- 
one will succeed in evoking the hallucinatory symbols in himself. 
Still the prime significance of the experiences as related is not 
affected. Not every one can be a poet or an artist, and yet the 
investigation of the psychology of artistic creation has universal 
human value. Silberer's method experimentally confirms the fact 
that in certain circumstances the psyche grasps at sensational-sym- 
bolic representation. One of my own patients has utilized this 
method for several months and has obtained remarkable insight into 
the unconscious and much freedom from severe compulsions. 

In further illustration Kaplan speaks of two symbolic hallucina- 
tions (hypnagogic visions) which he was able to evoke in himself. 
Just before going to sleep he forced himself to think about the 
tragic heroes and criminals. There then arose the First Vision. A 
half lighted room. A man and woman. It appears the man has 
surprised the woman. But he is hit by the woman. 

The theoretical thought which here struggles for expression is as 
follows : " The tragic hero signifies the criminal in us. Because he 
has overstepped the ethical norm suggested by society, he must 
finally fall, like the criminal who must expiate his deeds in punish- 
ment." In the vision one sees actually the criminal whom his deeds 
do not profit but who gets his punishment (the tragic situation). 
But as, according to psychoanalytic views, the sexual symbolism 
plays a dominating part in the unconscious, there appears in the 
vision not only the criminal but the sexual criminal. 

Another time before going to sleep Kaplan thought of the con- 
nection between the Flying Dutchman and the incest feeling. There 

23 Weinhold, Ueber die Bedeutung des Haselstrauchs, Zeitschr. d. Ver. f. 
Volksk., Vol. II, p. II. 

24 H. Silberer, Bericht iiber eine Methode, gewisse symbolische Halluzi- 
natlonserscheinungen hervorzurufen und zu beobachten, Freud-Bleuler's 
Jahrbuch, Vol. I. 



148 THE TECHNIQUE OF PSYCHOANALYSIS 

arises the Second Vision. Infinite stellar space. The Flying 
Dutchman cloaked in a dark robe soars in this space. The scene 
gradually changes. He sees before him Raphael's Madonna bril- 
liantly lighted. The change took place in the condensation of the 
stellar space into the canvas of the picture. 

The vision has given a sensational form to the theoretic thoughts : 
"Because he rested too much on the mother (Raphael's picture) — 
he must be very unrest ful when grown up (the soaring of the 
Dutchman) ."^^ That the confirmation comes only after that which 
is to be confirmed is quite congruent with not logical but psycho- 
logical succession; one thinks first of a thing and then one tries to 
comprehend it from the conditions of its existence and origin.^^ 

The hallucinations, Silberer notes, are usually connected with 
the unconscious. In order to turn a theoretical thought into a 
hallucination it is necessary to have, besides the individual factors, 
two things : a very sleepy state and an intense activity of thought. 
"A connection between the hallucination and the waking thought 
. . . results only if the latter is full of energy. If one sets about 
aiming at a transmutation of the waking thought into a symbol one 
must supply the latter with attention by force of will. If this is 
not done, the complexes already loaded with affect will get possession 
of the person going to sleep and, without regard to the waking 
thoughts, will themselves seek to attain symbolic representation."^^ 
If it is noticed that a very sleepy state, or one related to it, does not 
appear well adapted to maintain theoretical thoughts by means of 
attention, it becomes clear why the scientist does not solve his 
problems in the hallucinatory way, why he is not a visionary but a 
thinker. The visionary is the unrestricted thinker, who for that 
reason follows the regressive path to its conclusion in the hal- 
lucination. 

If strong affective states predominate in the mind of the indi- 
vidual, they make the "pushing forward" of the idea difficult, as 
they " deprive the function of attention of a part of its energy in 
claiming it for the autonomous complexes. The affects are not 
satisfied by disturbing the apperceptive function. Besides the nega- 

25 The foundation of this thought will be seen in Max Graf. Rich. Wagner 
in the " Flying Dutchman," Schrift z. angewand. Seelenk., edited by Freud, 
1911, Vol. 9. 

26 The interpretation of dreams is based regularly on the fact that many 
dreams must be read backwards in order to be understood. Freud. 

^'^ Silberer, Ueber das Symbolbildung, Freud-Bleuler's Jahrbuch., Vol. 3, 
p. 718. 



OVERCOMING THE CONFLICTS 149 

tive result they perform also a positive work in that by virtue of the 
attention energy turned to them they seek to give currency to the 
complexes to which they belong."^^ This state of affairs is found 
in the case of the power of the myth-making phantasy, dream, fable, 
religion and the visions of psychoneurotics. 

The second vision, Kaplan states, is not only the materialization 
of a definite idea, it has also a concealed background. It has already 
seemed remarkable that one should meet the Dutchman in the role 
of a phantastic aviator instead of on the open sea. The infinite 
stellar space was however the scene of a countless number of stereo- 
typed flying dreams, which the author dreamed as a child. The 
Flying Dutchman is therefore the writer himself. And during the 
last five or six years he has been forced to wander from one place 
to another without ever settling anywhere. His longing for home 
is, however, very great. The Flying Dutchman therefore turns into 
a little child that rests on the arm of its mother and may therefore 
feel safe from all troubles. A complex is associated with the theo- 
retical thought and finds its expression in the hypnagogic vision. 
This analysis, Kaplan shows, provides one at the same time with 
a very valuable insight : The adult yearns retrogressively from the 
struggles and privations of life tozvard the safe haven of childhood. 
On this is based the chief factor of the power of the infantile in the 
mental life of the adult. This constantly recurring infantile form 
of representation must constantly be kept in mind. 

I had thought to go into Stekel's very illuminating chapter on 
dream interpretation, but this has already been provided for in the 
January, 191 7, number of the Psychoanalytic Review. The 
beginning analyst should read this carefully as it clearly brings out 
how the various parts of the dream, when analyzed, lead to the 
unconscious of the dreamer. 

Before closing this chapter I would again emphasize how im- 
portant Freud's " Interpretation of Dreams " is for the analyst. 
For the very beginner it is a very difficult text, but as soon as one 
has commenced earnestly to pick out the dream meanings by the 
method of free association, this work can be read and reread to 
advantage. I have read it several times and with additional ex- 
perience each rereading shows new matter and helps to explain 
what has been heretofore quite dark. There are still parts of it 
quite inexplicable to me although several thousand dreams have been 
torn apart and subjected to analytic research. Even the expert 

28 lb., p. 685. 
II 



150 THE TECHNIQUE OF PSYCHOANALYSIS 

urine analyst has much to learn of this comparatively simple 
product of the kidney activity; how much the more in need of ex- 
tended research then is the enigma of the activity of the mental 
machine during the sleep period. 

One way of looking at dreams has enabled me to understand 
them much better and also permitted a graphic representation, which 
I here hazard, as pMDssibly affording some help to others. 

It is fairly well recognized that all final expressions of the human 
activity, conduct or behavior — as they are variously termed — arise 
from the depths of feeling. From the unconscious this " wish " or 
desire part of us gradually rises into consciousness to further the 
" work in hand," through appropriate, that is, " censored " activity. 
" The cerebral mechanism is arranged just so as to push back into 
the unconscious almost the whole of our past." This is Bergson's 
way of expressing what Freud calls the "censor" "and allows 
beyond the threshold only that which will further the action in 
hand." This latter we call conduct or behavior — the filtrate through 
the censor. " Our past then is made manifest to us in the form of 
impulse, it is felt in the form of feeling, whereas only a small part is 
known in the form of idea." 

This struggle upward I have tried to picture by an inverted cone. 
At the bottom is the core of generalized and highly condensed feel- 
ing and impulse, the rich background of the unconscious and archaic 
inheritance of all past experiences and values. From this well of 
feeling there comes surging to the surface some group of wishes, 
which, rising, separate out into the most primitive symbolic ex- 
pressions of the same. As these symbols rise towards the surface 
they undergo various branchings, resymbolizations — ^the mechanisms 
of condensation, displacement and distortion that Freud so well 
describes. Finally they arrive at a point where the censor, or 
psychic diaphragm, cuts them off, they are now presentable to the 
censor. Then through secondary elaboration the manifest content 
of the dream appears in consciousness and is the material upon 
which the analyst works. 

The method of free association now endeavors to lead backwards 
along the pathways that the feeling ascended from its sensational 
core to its resymbolized concrete intellectual image. 

Manifestly there are many, many trends in this upward surge 
and no graphic can encompass the complex splittings, but I shall take 
a comparatively simple dream and endeavor to fit it into this graphic 
form of representation and illustrate a few of the points which have 
been discussed at length. 



OVERCOMING THE CONFLICTS 



151 



Thus the patient dreams : G. (sister) and I are settled down. 
M {brother) and S (his wife) come around to the house to see us. 
S has a check to settle a little debt. G. is no longer there. M says 
"I'll be damned if we do." I awake, and there is some sort of an 
idea of decision to live in a certain sort of a way. There is a sort 




SEPARATION BY 
DUPLICATION IN DREAM 



DEEP PRIMITIVE 
ARCHAIC LEVEL 



Rough and schematic illustration of the gradual transformation of the 
primitive archaic reproductive instincts wish as it passes to conscious ex- 
pression in the dream as indicated in text. The chief points illustrated are 
the distortion by duplication. Dreamer I and M are brothers. G, a sister. 
S, wife of M, and the marriage wish of the dream. G and I are settled down. 
M and S come to visit us. 



of an implication in the dream toward conservation of resources or 
fight for a living. The dream is extremely simple in form. The 
multiplicity of arising associations cannot be given, for discretionary 



152 THE TECHNIQUE OF PSYCHOANALYSIS 

reasons. Furthermore the dream is to be used only to illustrate in 
part the scheme which has just been spoken of. 

Before reducing certain features of it to graphic form attention 
should first be called to two of Freud's statements in his "Interpre- 
tation," which book, as has been said, should have been thoroughly 
read by the analyst, or else these articles on technique will be of 
little service. He says one looks first of all for the feeling in the 
dream. If there is any distinct sense of feeling tone it must be used 
as the main pathway of approach to the dream. Then again, if 
spoken words occur in the dream they may be taken more or less in 
a literal sense. That is they are less distorted products of the dream 
work, most conscious. 

The feeling tone of this dream does not tell much of anything 
save as to a conflict of the dreamer, whether by saving his money 
he can conserve his resources and continue not doing any work, 
which latter is so difficult, if not impossible, for him, or to get out 
and hustle and be obliged to work. 

But there is the heard speech, " I'll be damned if we do." Do 
what? I shall start my cone then with this statement and speak 
of this stratum of the dream as the conscious stratum. In this 
stratum there are three characters only. M, the brother, S, the 
sister-in-law, and the dreamer. One has been eliminated, G, the 
sister. This is represented in the graphic by the small circles as, 
marked. The position as to the next stratum of the dream appears 
also in the manifest content, G and I are settled down, S and M come 
to see us. 

Why has the sister been eliminated at the conscious level? If 
one trend of the dream be expressed in this graphic way it is not 
impossible to see that the dreamer has finally forced himself to the 
conviction that his unconscious incestuous bond to the sister is one 
of the important links in the construction of his neurosis. The 
conscious attitude to the sister, it need hardly be said, is one of 
" intense antagonism." Nor is it to be wondered at that the sister 
also has a severe neurosis. The dream also shows that the way in 
which he handles his money, or rather the way in which he permits 
his brother to handle it, is his conscious, behavioristic manner of 
hanging on to the unconscious incestuous phantasy through its dis- 
placement to the anal erotic hate complex. 

For the first time, following this dream, the patient, using Sil- 
berer's hallucinatory method, was able to finally reproduce the early 
infantile erotic sensations in relation to the sister. This relation- 
ship he had most persistently resisted as a possibility. 



OVERCOMING THE CONFLICTS 1 53 

This illustration is almost too simplistic to present, but if the 
analyst will try to picture to himself, in terms of the different strata 
of the dream thoughts, the condensations, distortions, splittings, dis- 
placements, etc., of the dream work, he will be able graphically to 
work out the chief stages in the unconscious erotic wishes of the 
patient and thus aid his patient to see them for himself. One can 
combine this form of graphic with those which immediately precede 
and 'obtain a fragmentary glimpse at the restless movements of the 
unconscious libido trends in their rapid differentiations and integra- 
tions. These finally result in action, showing themselves either as 
the metabolism of the body cell groups, or as conduct. 

Before finishing this discussion I would call attention to a 
further bit of the work of the unconscious, glimpses of which may be 
read in the dream and which throws a searchlight into the possibili- 
ties of the future of the race. It has been held up as a reproach to 
psychoanalysis that it looks backward only. This is not in the least 
true. True it is like the weaver who must stop his machine to pick 
up a dropped stitch in order to go forward. The psychoanalytic 
method is a method for finding these dropped stitches — fixations — 
which prevent the use of part of the individual's energy for sublima- 
tion purposes. It goes back into the machinery to repair this diffi- 
culty in order that the individual may live a fuller and more com- 
plete life. 

Practically all of man's activities come out of his unconscious. 
They push forward to keep the race in that path which will lead to 
further evolution. If 100,000,000 years have seen the ascent from 
colloidal ooze to man, what will the next same time span reveal and 
what agencies are at work to keep the individual and the race in the 
" strait and narrow path that leadeth unto righteousness,'* that is, 
race immortality ? 

In order to obtain a closer practical view of just what is meant, 
I cannot do better than to refer to Maeder's^* stimulating work on 
the progressive aspect, the so-called prospective function, of the 
dream in the individual conflict. For it is the individual who em- 
bodies the epitome of the race and the individual activities which 
constitute racial development and progress. Moreover it is the 
dream which reveals most completely this individual in his control- 
ling tendencies, if we consider it as revealing the two aspects, that 
which draws him back within himself and retards progress and like- 
wise those tendencies which belong to his intrinsic and immortal 
spirit of progress. 

29 Maeder, The Dream Problem, Monograph Series, No. 22. 



154 '^^^ TECHNIQUE OF PSYCHOANALYSIS 

Maeder's emphasis, therefore, upon this side of the dream and its 
therapeutic value is merely a furthering of the complete psycho- 
analytic work. It is the goal toward which all of Freud's work 
tends, toward which his whole effort is directed. Yet it was neces- 
sary in the beginning to lay repeated stress upon the necessity for 
"the most exhaustive occupation with (the complexes )"^^ and thus 
Maeder thinks the revelation in the dream of the progress of the 
patient in regard to his conflict and his life task has lacked emphasis. 

It must not be forgotten that the illness is due to a conflict be- 
tween these opposing tendencies, so that the dreams, arising out of 
this same unconscious, which is the source of activity and conduct, 
would be expected to present both sides of the struggle. As Maeder 
points out, the reaction formula is already in the child. On one 
side are his egoistic wishes controlled by the pleasure-pain principle, 
through which he seeks to have them fulfilled. Offset against these 
is the life plan to which his inherent progressive tendency, his im- 
mortality, compels him. The whole aim of the analytic investiga- 
tion of the dream, as Freud has expounded it, is to liberate this 
progressive tendency, the libido, from its fixations on the opposite 
side. 

Maeder's point is this, that the dream itself in its manifest con- 
tent as well as in its appropriation of clinical setting in the course 
of treatment, makes use of what, according to Freud's terminology, 
may be called intrapsychic perceptions and images of the situation 
as it exists in the unconscious, or what Silberer terms autosymbol- 
ism. By this means the dream manifests the stages of development 
of the neurotic conflict or in general of the personality itself. It 
shows, as Maeder's illustrative dreams make clear, the patient's 
insight into his problem, his conflict and the progress he has made 
toward acceptance of the life task. It presents therefore both the 
resistance and retardation which arise and the resolving of these, 
which is largely accomplished through the analysis of them as they 
thus appear in the manifest content. 

Maeder has made use of three happily chosen forms of illustra- 
tion. The first consists of a number of dreams occurring at suc- 
cessive periods of the analysis, with also a few dreams chosen from 
other patients. In the second place he borrows from Freud's " In- 
terpretation of Dreams " the recurrent dream of the poet Rosegg^r 
and submits these to the same test for the prospective and heahng 

30 Freud, History of the Psychoanalytic Movement, Monograph Series, 
No. 25. 



OVERCOMING THE CONFLICTS 1 55 

function, extending thus beyond Freud's original analysis into the 
teleological service the dream rendered to the poet's actual attitude 
toward life. Finally he has utilized a second dream reported and 
analyzed by Freud, that of a nurse, in which the dream reveals the 
unwillingness of the individual to solve her problem and bring her- 
self into an adjustment with life's demands. 

Perhaps one of the clinical dreams will be best for incorporation 
into our discussion. I must content myself with an abbreviated 
reproduction of these dreams and their analyses and their place in 
the treatment as Maeder has reported them. "The dreamer is a 
youth of 18; he comes of a good family, of old stock which possesses, 
however, numerous neurotic features. He grew up between a 
father who was severe and violent in his demands, but who taken 
altogether, was quite lovable, and a mother who is gentle, yielding^ 
sensitive and cultured. . . . He succeeded in being his own master, 
by allowing his own desires and moods and interests to dominate 
his life. Gradually tremendous gaps were noticed in his develop- 
ment. There followed a chasing from one school to another. After 
some years the youth emerged from these circumstances, quite un- 
improved and extraordinarily ignorant. Psychoanalytic treatment 
was then begun, side by side with suitable teaching and education. 
. . . after two years he was able to do a good piece of work in 
proper time. The dream analyzed belongs to a time during the 
analysis when the youth had overcome the worst difficulties and the 
severest conflicts. . . . The dream runs as follows: [I omit the 
first part, which is not here analyzed and also the gathering of 
associations, quoting the analysis made from them.] ^'With a 
bicycle, we [dreamer and his sister] then rode further, to the lake 
[in Zurich], where we met O. and a man on horseback in a green 
uniform. He rode on a horse that had a beautiful blue coat. 
Before he came to the bridge he dismounted and showed the left 
foreleg of the blue horse to a boy, who suddenly appeared. After- 
wards some gentleman spoke to us about Dr. D. and spoke of a 
check number which he had taken by mistake. I then offered to 
take it with me [to the doctor who lived in a higher part of the 
town] but he said he had already arranged something with his 
sister. 

"... According to the dreamer, the scene with the blue horse 
is the center of interest in the dream, the emotional interest is very 
strong here. It is necessary to remark that the horse has much 
significance for the dreamer himself and for his whole environment. 



156 THE TECHNIQUE OF PSYCHOANALYSIS 

... If we use the material, thus obtained [through the associa- 
tions], for interpretation, we find, in the first place, in the surface 
layer, on the objective level (to use Jung's excellent expression) the 
following : 

" The blue horse is the beloved. . . . The horse represents more 
— the girls who have a magnetic effect, the mother, whose sexual 
significance is brought out by the scene in the bath during childhood 
[according to the associations] . 

" The green officer, his model, is the dreamer himself, who rides 
the horse, his beloved, with whom he made the tour (ride) that 
time. A parallel to this is furnished by the first part of the dream. 
. . . His sister, who here replaces the beloved, is the one with whom 
he carried on most of his childish tricks and for whom he has a 
strong transference. 

"The officer examines the horse with the boy. The latter [a 
stable boy] is also identified with the dreamer, . . . his meaner ego. 
... By the choice of this symbol the dreamer measures his own 
value, saying ' I am also a low down fellow/ . . . One has been 
riding the horse too hard. In the same association we have also 
the masturbation, against which our dreamer has been fighting in 
vain for some time. . . . Accordingly, the dreamer is also identified 
with the horse. . . . And so we have arrived at the lower stratum, 
what Jung calls the subjective level. The horse becomes a symbol 
of the libido; a symbol of his own libido. In this stratum, note 
well, all symbols refer to the dreamer himself, and they are to be 
regarded as personifications of the different tendencies of his psyche. 
What on the objective level was regarded as the symbol of the 
beloved, becomes, on the subjective level, a symbol of that libido 
which has a tendency towards the object (the tendency is symbol- 
ized by its goal!). 

" This part of the dream tells us then : L. (the dreamer) has ridden 
too hard, something is not right with me, and must be looked into. 
. . . That is to say, insight is dawning on the mind of the dreamer. 
After external separation from the beloved, ... he was still in- 
tensely bound up in her internally. Because of the analysis he feels 
impelled to break with her, as he gradually came to see — although 
merely intellectually — how harmful their adventure had been for his 
development. . . . Inwardly he was not willing at the time to break 
with her ; but he hid himself and his opposition behind me, the scape- 
goat. This dream shows us a further step. . . . His insight into his 
situation, the correct valuation of his adventure, becomes at the 



OVERCOMING THE CONFLICTS 1 57 

time of the dream emotional, not merely intellectual. This insight 
with the double character of intelligence and affect, is very signifi- 
cant and forms a cardinal point in the cure by analysis ; for whoever 
possesses this insight is really acting on his own principles and con- 
viction and thereby occupies a different relation towards the analysis 
from at first. The physician is no longer one who asserts this or 
that; something which one accepts or rejects, according to the pre- 
dominance of the positive or negative attitude, but he has become a 
leader who sees and points out what one carries in oneself and only 
recognizes with difficulty ; the physician is now he who helps one to 
know oneself better and how to rule oneself. . . . 

" The last part of the dream which deals with the conversation 
about the doctor and the number, is little plastic in its manifest 
content, and is poor also in its latent content. . . . An entire side of 
the problem of the development of the libido in the youth is still un- 
touched, he is not yet capable of clearly viewing the realization of the 
insight he has won, much less of bringing it to pass. . . . This . . . 
segment is [for Maeder] a symbolic expression of the future and 
as yet insufficiently elaborated material. . . . The principal stress of 
the manifested dream is laid on the wonderfully beautiful blue color 
of the horse, by which, in his opinion, is expressed how . . . great 
an attraction enjoyment still holds for him. This picture contains a 
valuation, which may serve as a standard for the dreamer's attitude. 
The task before the dreamer is the conquest of the kingdom in which 
the reality principle, to use Freud's excellent expression, reigns. 
. . . This is a point of cardinal importance in the analysis. It . . . 
indicates . . . the beginning of upward progress. 

"... The psychoanalyst does not appear merely as physician 
in the last part ; but also in the middle portion of the dream, namely, 
hidden behind the boy and probably also under the form of the 
officer. These two conduct the examination. The dreamer's identi- 
fication with the boy points to the negative side of the transference 
he feels towards his physician ; the physician takes the place of the 
father whom the dreamer fears. . . . But gradually the physician 
has become to the youth a model in some points. . . . Thus the 
dreamer identifies the two models. ... I must add that the youth 
was advanced considerably through this analysis, and that he at- 
tacked the further solving of his problem with great earnestness." 

Maeder's consideration of the dream in this aspect by no means 
denies the existence of a close connection between the latent and the 
manifest dream content. We can see here how both belong to the 



158 THE TECHNIQUE OF PSYCHOANALYSIS 

complete picture and the manifest content, as he states, can be 
valued and interpreted only by means of the latent dream material. 
The affect also, which accompanies the dream, as the above analysis 
shows, gains in this way a distinct value in recording the patient's 
progress. Particularly it expresses that most important step in the 
treatment, the passing over from a mere intellectual acceptance of 
the facts of the analysis, whether in interpretation of the underlying 
complexes or in recognition of the task to be accepted, to an emo- 
tional appreciation and appropriationi of the same. Intellectual ac- 
ceptance can work no cure but may prove seriously misleading to 
the patient who is attempting to grasp the situation and to the be- 
ginner in analysis as well. Therefore the value of this function of 
the dream in bringing not only to the analyst but more significantly 
to the patient himself the realization that the self-revelation and the 
actual life task in its concrete forms is being seized upon by the 
wish nature. For thus they become a part of that unconscious which 
Bergson so impressively describes "leaning over the present . . . 
pressing against the portals of the conscious " in order to " further " 
the work in hand for the individual in his share in racial achievement. 

The seriousness of the task with which the psychoanalyst is 
confronted would be overwhelming were it not for the nature of the 
material with which he has to deal. This it should be remebered is 
dynamic and plastic. The very method which psychoanalysis em- 
ploys enables one to take this material bit by bit, slowly, cautiously, 
the greater vision as well as the dynamic possibilities for good or 
ill always kept in mind, and by careful detailed work search out 
the libido lost in its regressions and remove the encrustations often 
of a lifelong maladjustment. Then, still through the analysis largely 
effectual on this side also by means of the dream, as we have seen, 
this libido is guided and stimulated to the acceptance and successful 
'accomplishment of life's tasks. One enters through that recogni- 
tion on the part of the conscious of the long divorced forces of the 
unconscious into a mutually intellectual and emotional knowledge of 
oneself, which means at last a true valuation of oneself. The libido 
is indeed free. 

The magnitude of this task together with its infinite reward to 
both patient and physician has urged upon me minute details of cau- 
tion and of direction. I have tried to show the value of a participa- 
tion on the part of patient and physician in the greater cosmic view 
both of the origin and development of that unconscious which must 
be investigated, as well as of its potentiality for the future of the 



OVERCOMING THE CONFLICTS 1 59 

race. There is necessary, likewise, the detailed appreciation of the 
individual effort to realize his position in society, his failure or 
success in handling the forces within him, and the guiding of his 
libido trends into a successful adaptive relation to cosmic progress. 

He fails, as we have seen, principally through the difficulty which 
persists with individual and race alike, the difficulty of severance 
from the past and of entering into an independent creative attitude 
toward the present and future. This problem is a very concrete one 
because of the love relation in which life begins and through which 
alone, in its broadest sense, progress continues. Therefore the 
problem resolves itself very definitely into the " family romance " 
situation, or in Freud's classic term the QEdipus situation. For this 
reason the psychoanalyst must recognize and accept the transfer- 
ence phenomenon as the most important manifestation on the part 
of the patient and learn to use it as the most powerful factor in 
receiving the patient's groping after assurance and health, that is 
after an effectual adaptation to reality, and use this bridge actually 
to transfer the libido striving into reality and the life task. 

The attempt has thus been made to point out the great trend of 
psychoanalysis and to set up a few guiding posts for the physician 
who would place himself actively in this movement. One thing 
further must never be lost sight of. The existence of the uncon- 
scious, though in one sense merely a pragmatic hypothesis, yet repre- 
sents an undeniable and inescapable fact. We do " desire, will and 
act " with our past. It is preserved in some way and preserved for 
some useful purpose. This immeasurable and unfathomable past 
cannot, however, be allowed complete nor unguided control. There 
must be direction and regulation. Hence the need to understand it, 
its content and its history and how to utilize its affective value. 
Hence also the external barriers and restrictions which culture 
throws out from time to time as guides and limitations to aid in its 
control. 

These are indispensable aids but they are not fixed. This past 
is the product of a stream of energy which so far as we are con- 
cerned is inexhaustible. It has not expended itself in building up 
the past, it contains unmeasured resources for the future. The 
millions of years back to the colloidal ooze only point to the millions 
of years ahead to we know not what. We only know that infinite 
possibilities of development lie before us which must continuously 
outgrow external barriers and limitations and form new ones. We 
know also that the thwarting of the creative impulse as it tries to 



l60 THE TECHNIQUE OF PSYCHOANALYSIS 

express itself in the various libido trends causes illness in any of the 
bodies activities and that these barriers sometimes exceed their use- 
fulness and increase to too great an extent the existing repression 
and obstruction. 

Society's great task therefore is the understanding of the life 
force, its manifold efforts at expression and the ways of attaining 
this, and to provide as free and expansive ways as possible for the 
creative energy which is to work marvelous things for the future. 
It is peculiarly the physician's task also to understand the failures 
and, searching out their causes, to bring back the misdirected energy 
to racial service and individual health and happiness. The reward 
is twofold and it comes in the direct path of detailed psychoanalytic 
service. It lies in the bringing of the individual into liberating self- 
knowledge and thus into racial achievement ; it moreover establishes 
the physician himself in a vital contact with the unconscious, the 
great energic source of all that life means, and it compels him to 
swing into line with cosmic progress and its creative possibilities. 
His is no small share in freeing and directing the energy whether 
in his patients or likewise in himself and in setting it to the molding 
and forming of reality. 



INDEX 



Adaptation to reality, 132 Ferenczi, 116, 120 

Adler, 78 Fixation, 132, 133 

Ambivalence, 91, 98 Fossils, thought, 130 

Anal erotic complex, prostitution as, Free treatment, 16, 34, 108 



52 
in resistance, infantile, 

115 

Anthropology and psychoanalysis, 23 
Archaic level, 129, 132, 135 
Auto-erotic level, 129, 134 

libido satisfaction, 42 

symbolizations, 47 
Autosuggestion, 126 



Freud, 87, 94 

" Interpretation of Dreams," 149 
Freud's writings, 23 

Golden Bough, 23 



Hall, Stanley, 67, 70, 79 
Heterosexual phantasies and trans- 
ference, 119 
History of psychoanalysis, 21 

taking of, 30 
Homosexual phantasies and trans- 
ference, 119 
resistance, 114 
Castration complex " in resistance. Hypnotism a transference phenome- 



Bibliography, 23 
Binet-Simon tests, 9, 31 
Biochemical level, 38, 39 



113 

" Castration motive," 64 
Compensation, psychic, 79 
" Complex indicators," 99 
Consciousness, 39 
Consultations, 19 

Dementia and psychoanalysis, 11 
Determinism, 7 

Diagnosis in psychoanalysis, 3 
Dreams " Announcement," 82 

in transference, 117 
Dream, transference in the, 81 



non, 121 

Immortality as libido striving, 66, 67, 

72 
Impotency, 67, 78 

Individuality in use of symbols, 138 
Infantile anal erotic and resistance, 

115 

Inferiority, organic, 79 

unconscious psychical, 79 
Intellectual acceptance of analysis, 

158 
Intro jection, 119 



Emotional acceptance of analysis, 158 Kaplan, 142 
Energy rivalry, 40 

Latent dream content, 158 

Facial musculature activities, signifi- Libido, 40, 66 

cance of, 99 distribution, 40 

Family neurotic romance, 30, 54 fixation, 133 

Fear, 67 floating, 87 

Feeblemindedness and psychoanaly- introversion of the, 88 

sis, 9 reduction of the, 137 

Feeling in dream, 152, 158 trends, partial, 44 

161 



l62 



INDEX 



values, fetal, 40 
Literattire of psychoanalysis, 21 

Maeder, 153 

Manic-depressive, transference of 

the, 18 
Manifest dream content, 157 
Masochism in hypnotic obedience, 

125 
Mental facts, taking of, 3 
Money complex, 34, 48 
" Myth of the Birth of the Hero," 54 

Narcissism in transference, 112, 113 
Narcissistic level, 130, 132, 133, 134 
Negative transference, 92 
Neurologic training and psycho- 
analysis, 23, 29 
Non-medical psychoanalyst, 20 
Nutritive libido, 40, 62 

CEdipus Complex, 48, 49 

as hypothesis, 52 

in transference, 108 
Old Testament, 23 
Organerotic level, 129, 132 
Ovidian level, 130 

Pain as a sensori-motor corrective, 

41 

Parent complex in hypnosis, 122 
in resistance, 114 

Partial libido trends, 44, 47, 62 

Patient's attitude toward disorder, 29 

Pelvic libido, 40 

Perversion, 43 

Philosophy and psychoanalysis, 23 

Physical disorders and psychoanaly- 
sis, 5 

Potency, 67 

Power, sense of, 43 

Preliminary program to treatment, 32 

Projection, 119 

Prospective function of dream, 153 

Prostitution, 52 
phantasy, 45 

Protagoras, 50 

Psychiatric training andl psycho- 
analysis, 23 



Psychoanalysis, " bad," 15 
contra-indicated, 6 
definition of, v 
impossible cases for, 9, 32 
of physician himself, 28 
unwise for certain cases, 12, 33 

Psychoanalytic goal, 158 

Psychognosia, 21, 22 

Psychogram, use of a, 130, 133, 135, 

151 

Psychology, 21 
Psychos ophy, 21 
Psycho synthesis, 38 
Psychozoic, 129 

Questionnaires, 31 

Race perpetuation, 46 
Rank, 54 

Receptor groups, 39 
Regression, 132 
Reik, 103 
Repression, 44 
Reproduction, 66 
Resistance, 88, 96 

in analyst toward other physi- 
cians, 118 

components of, 113 

as a defense, 103 

in hypnosis, 126 

signs of, 100 
Respiratory libido, 40 
Resymbolizat'ions of wish, 151 

Self-preservation, 46 

Separation of parent and child, 56 

Sexual, meaning of term, 52 

Silberer, 147 

Skin libido, 40, 41 

Socialization of the libido, 131, 132 

of the personality, 128 
Social period, 130, 132 
Special senses, libido in, 40 
Stekel, 18, 19 
Sublimation, 42 

Suggestion, a transference phenome- 
non, 120, 125, 126 
Symbol groups, 140 
Symbolic hallucinations, 147 



INDEX 



163 



Symbolism of dream, 137 

number, Z7 
Symbols, generalized, 141 
Symptoms, importance of little, 28 
Synthesis, 130 

Thanatophobia, 69, 70 

Time element in development, 37 

for treatment, length of, 34 
Transference, 18, (i^, 87 

analyst's own negative, 112 

dissolving of, no 

in dream, 117 



dynamics of the, 87, 94 

a dynamic therapeutic agent, 81 

a general phenomenon, 88, 91, 92, 
120 

hysterical, 17 

in manic-depressive cases, 18 

mismanaged, 34 

negative, 90 

positive, 90 

as security, 70, 78, 81 

signs of, 98 
Tropisms, 39, 42 
Unconscious, hypothesis of the, 35 



__jlS 



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